US20070016208A1 - Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder - Google Patents
Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder Download PDFInfo
- Publication number
- US20070016208A1 US20070016208A1 US11/482,038 US48203806A US2007016208A1 US 20070016208 A1 US20070016208 A1 US 20070016208A1 US 48203806 A US48203806 A US 48203806A US 2007016208 A1 US2007016208 A1 US 2007016208A1
- Authority
- US
- United States
- Prior art keywords
- button
- suture
- washer
- apertures
- clavicle
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0404—Buttons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
Definitions
- the present invention relates to an apparatus and a method for internal fixation of an acromioclavicular joint dislocation of the shoulder with resultant superior migration of the lateral end of the clavicle with respect to the acromium and the coracoid of the scapula.
- Acromioclavicular (“AC”) joint dislocations are characterized by severe upward displacement of the lateral end of the clavicle relative to the acromium of the scapula. Surgery is recommended to reduce and internally fix the displacement, which could otherwise lead to a painful deformity and loss of function.
- This invention relates to reconstruction surgery and particularly to reconstruction surgery for Rockwood types II-VI AC joint dislocations of the shoulder (Rockwood, Williams, & Young, Injuries to the Acromioclavicular Joints, in FRACTURES IN ADULTS 1341-1413 (Rockwood & Green, eds., 3 rd ed., 1996)). More particularly, the invention relates to the use of a first suture anchor-suture-second suture anchor technique to reduce and internally fix the dislocation between the clavicle and the coracoid process.
- Injuries to the AC joint are generally classified as types I-VI, depending on the type and amount of disruption to the AC and the coracoclavicular ligaments.
- a type III AC dislocation of the shoulder is a common injury that occurs primarily from having a fall to the point of the shoulder.
- a type III injury is characterized by disruption of the AC and coracoclavicular ligaments, the dislocation of the AC joint and the upward relative displacement of the lateral end of the clavicle.
- the coracoclavicular interspace is greater than in the normal shoulder.
- the non-operative option includes external, closed reduction.
- Various external, closed reduction procedures have been tried in the past using straps, casts, and different taping techniques. Generally, it has been believed that the procedures would work if applied continuously. Unfortunately, it has been found not to work as no one can wear them continuously because of skin breakdown and discomfort. As a result, such treatment regimes rarely have been successful. The patient must inevitably accept a cosmetic deformity and suffer from pain and fatigue after prolonged physical activity or heavy lifting.
- Non-operative treatment options generally provide unacceptable results.
- the open reduction treatment while providing generally good results, has the disadvantage of an in-hospital stay plus the extensive time required for healing and rehabilitation.
- a surgical outpatient technique that would correct the deformity and allow healing of the injury in a normal anatomic position without extensive tissue dissection and less scarring would provide a substantial improvement over current treatment methods.
- the present invention relates to a surprising use of a first suture anchor-suture-second suture anchor technique.
- the proposed method of the present invention is simple and is performed by a mini-open approach.
- an apparatus for use in internal fixation of AC joint dislocations of a shoulder is a kit of parts for internal fixation of an AC joint dislocation of a shoulder, the shoulder including a clavicle, a coracoid process and an acromium, the kit of parts comprising a first suture anchor; a second suture anchor, the first and second suture anchors being adapted for engagement in or on the clavicle and the coracoid process, respectively; a flexible coupling mountable, in use, between the first and second suture anchors; and a needle releasably securable to at least one of the first and second suture anchors, in which the first and second suture anchors each have at least first and second apertures and the flexible coupling is a first suture which is double looped through the first and second suture anchors.
- the first suture is fed, in use, through a first aperture of the second suture anchor, and through, in turn, the second and first apertures of the first suture anchor and through, in turn, second and first apertures of the second suture anchor, and through, in turn, the second and first apertures of the first suture anchor and through the second aperture of the second suture anchor.
- the first suture anchor comprises a button and the second suture anchor comprises a washer, the washer being adapted and dimensioned to engage with a bone anchor.
- each of the first and second suture anchors can be a button.
- each of the first and second suture anchors can be a washer, the washer being adapted and dimensioned to engage with a bone anchor.
- the first suture anchor is a washer and the second suture anchor is a button.
- the bone anchor may be a bone screw, a bone nail, a bone staple or an intraosseous bone anchor. A bone screw is preferred.
- the washer has a central aperture and at least two, preferably at least four, peripheral apertures, the central aperture being adapted and dimensioned to accept a bone screw.
- the first suture anchor is a button having an oblong body and first and second apertures and the second suture anchor is a washer adapted to engage with a bone anchor and having at least two, preferably at least four, peripheral apertures.
- the first suture is fed through a first peripheral aperture of the washer and through, in turn, the second and first apertures of the button and through, in turn, second and third peripheral apertures of the washer, and through, in turn, the second and first apertures of the button and through the fourth peripheral aperture of the washer.
- a loop is formed on the underneath of the washer, by the path of the first suture between the second and third peripheral apertures. If desired, the free ends of the first suture may be fed under this loop, to provide a self-tightening suture.
- the needle is preferably secured to one or both of the first and second buttons by means of a second suture looped through one of the first or second apertures of the first and/or second buttons, the second suture being operatively associated with the needle.
- a method for internal fixation of AC joint dislocations comprises the steps of providing an apparatus according to the first aspect of the present invention; securing the first and second suture anchors on or adjacent the clavicle and the coracoid process, respectively; and reducing and fixing the distance between the clavicle and the coracoid process, by traction of the flexible coupling.
- the method preferably comprises the steps of drilling a clavicle hole through the clavicle and a coracoid hole into the coracoid process; passing the needle through the clavicle hole, so as to advance the button longitudinally through the clavicle hole; pivoting the button so as to engage the button against a superior surface of the clavicle; inserting a screw through a central aperture of the washer into the coracoid hole in a superior aspect of the coracoid process; and reducing and fixing the distance between the clavicle and the coracoid process, by traction of the flexible coupling.
- the needle is uncoupled from the button when the button has been advanced through the clavicle hole and has engaged against the superior surface of the clavicle.
- traction of the flexible coupling can be effected by hand traction or by the use of a suture tensioner.
- Suitable suture tensioners are well known in the art.
- a button for use in the apparatus of the first aspect of the invention and for use in the method of the second aspect of the present invention.
- the button of the third aspect of the invention can be used as either the first or second suture anchor or as each of the first and second suture anchors.
- the button of the third aspect of the present invention may comprise an oblong body defining first and second apertures.
- each of the first and second apertures is oblong, their longitudinal mid-lines being located substantially about a longitudinal mid-line of the oblong body.
- each of the first and second apertures is substantially triangular in plan view.
- each aperture is tapered and terminates in an apex, the apices being directed away from each other.
- each of the apertures comprises first, second and third walls and the first walls of the respective first and second apertures are substantially parallel.
- the button of the third aspect of the present invention may have any suitable dimension (width, length and thickness). If the button is oblong, for example, the button of the third aspect of the present invention can have a width of 2.5 mm to 4.0 mm without compromising implant strength, although a width of 3.0 mm to 4.0 mm is preferred.
- the length of the button of the third aspect of the present invention is less critical but may, for example, be in the range 7.5 mm to 12.5 mm. A length in the range 9 mm to 11 mm is preferred since the button of the third aspect of the present invention is then slightly less palpable under the skin following implantation.
- Each of the first and second apertures of the button of the third aspect of the present invention may have any shape or geometry.
- one embodiment is an aperture which is substantially triangular in plan view.
- Another embodiment is an egg-shaped or oval aperture, the curved narrower end comprising the apex.
- a washer for use in the apparatus of the first aspect of the invention and for use in the method of the second aspect of the present invention.
- the washer of the fourth aspect of the invention can be used as either the first or second suture anchor or as each of the first and second suture anchors.
- the washer of the fourth aspect of the present invention comprises a body adapted for engagement with a bone anchor and having at least two, preferably at least four, peripheral apertures.
- the washer of the fourth aspect of the present invention optionally comprises a disc-shaped body defining a central aperture shaped and dimensioned to accept a bone screw and having four peripheral apertures.
- each of the central and peripheral apertures is circular in plan view.
- the washer of the fourth aspect of the present invention can have an external diameter of 6.5 mm to 13.0 mm and a thickness of 1.0 mm to 2.0 mm without compromising implant strength, although an external diameter of 8 mm to 12 mm and a thickness of about 1.5 mm is preferred.
- the central aperture of the washer of the fourth aspect of the present invention can have an internal diameter of 2.5 mm to 6.5 mm, although an internal diameter of 3.5 mm to 5.5 mm is preferred.
- the four peripheral apertures of the washer of the fourth aspect of the present invention can have an internal diameter of 0.5 mm to 2.0 mm, although an internal diameter of 0.8 mm to 1.2 mm is preferred.
- buttons or “washer” is intended to mean any suitably shaped and dimensioned suture anchor or stress bearing member which is capable of transmitting a force incident thereon to any body with which the button or washer is in contact.
- FIGS. 1 and 1 a show an anterior view and a schematic view, respectively, of a normal acromioclavicular joint
- FIGS. 2 and 2 a show an anterior view and a schematic view, respectively, of a Rockwood Type III acromioclavicular joint dislocation, with superior migration of the clavicle with respect to the acromium;
- FIG. 3 shows a plan view of a first or second suture anchor in the form of a button of the present invention
- FIG. 4 shows perspective, plan and sectional view of an alternative embodiment of a button according to the invention
- FIGS. 5 and 5 a show a plan and an undersurface view, respectively, of a first or second suture anchor in the form of a washer of the present invention
- FIG. 5 b illustrates the mobile positioning of the washer against an arcuate undersurface of the screw-head of a bone anchor
- FIG. 6 shows a perspective view of the kit of parts comprising an apparatus of the present invention.
- FIGS. 7 a - 7 f illustrate, in sequence, the steps of a method according to the present invention.
- the present invention provides minimally invasive, flexible fixation of the AC joint dislocation by resisting superior migration of the clavicle with respect to the coracoid process. It allows physiological micromotion at the AC joint. There should be no need for routine removal of the implant.
- the present invention is indicated for use in the fixation of AC joint dislocation.
- AC joint dislocations typically seen in Rockwood type III AC joint dislocations, usually caused by severe downward blunt trauma to the point of the shoulder, or acromium.
- the clavicle is upwardly displaced as a result of the injury because of disruption to the AC and coracoclavicular ligaments. Reduction and fixation of displaced AC joint dislocations are necessary to prevent painful deformity and loss of function.
- FIGS. 1 and 1 a show anterior and schematic views of a normal shoulder 10 .
- FIGS. 2 and 2 a show anterior and schematic views of a shoulder 10 that has suffered a Rockwood type III AC joint dislocation injury.
- the structure of a shoulder 10 relevant to a Rockwood type III dislocation injury includes the clavicle 12 , the coracoid process 14 and the acromium 16 .
- the acromium 16 and the clavicle 12 are connected by the acromioclavicular ligament 18 .
- the acromioclavicular ligament 18 extends from the lateral end 20 of the clavicle 12 to the medial surface 22 of the acromium 16 .
- the coracoid process 14 is connected to the clavicle 12 by the coracoclavicular ligaments 24 , which comprise the trapezoid ligament 26 and the conoid ligament 28 .
- the coracoclavicular ligaments 24 extend from the inferior surface 30 of the clavicle 12 to the superior surface 32 of the coracoid process 14 .
- a Rockwood type III AC joint dislocation is characterized by the disruption of the AC and the coracoclavicular ligaments 18 , 24 , respectively.
- the clavicle 12 separates from, and moves away from, the coracoid process 14 and the acromium 16 , accompanied by disruption of the coracoclavicular and the AC ligaments 18 , 24 , respectively.
- the acromioclavicular joint 34 ( FIG. 2 ) is dislocated and the clavicle 12 is relatively displaced upwardly.
- the coraco-acromial ligament 36 ( FIG. 1 ) is not impacted in the type III shoulder dislocation.
- Repair of the type III shoulder dislocation is an out-patient procedure performed with a general anesthetic.
- the procedure is done with the patient lying supine on the operating table, preferably in the “deck-chair” position to allow the surgeon full access to the affected shoulder.
- the apparatus of the present invention comprises a first or second suture anchor in the form of a button 50 , which, in the embodiment illustrated, is about 10.0 mm in length by about 3.5 mm in width.
- the button 50 is preferably formed from titanium or stainless steel, although it will be appreciated that any other suitable material could be used, in particular any suitable bioabsorbable material.
- the button 50 has a first aperture 52 and a second aperture 54 which, in the embodiment illustrated, are oblong in shape, the longitudinal mid-line of each of the first and second apertures 52 , 54 being located substantially about a longitudinal mid-line of the button 50 .
- first or second suture anchor generally indicated as 150 .
- the button 150 is about 9.0 mm in length by about 3.5 mm in width, with a thickness of about 1.5 mm.
- the button 150 has first and second apertures 152 and 154 , respectively.
- each of the apertures 152 , 154 are triangular in shape, the respective apices 155 being directed away from each other and being located substantially about a longitudinal mid-line of the button 150 .
- FIGS. 5 and 5 a illustrate a first or second suture anchor in the form of a washer 60 .
- the washer 60 has an external diameter of about 10.0 mm. While the illustrated washer is disc-shaped, the washer is not so limited.
- the washer 60 is preferably formed from titanium or stainless steel although, as will be appreciated by those skilled in the art, any other suitable material, in particular any suitable bioabsorbable materials, may be used.
- the washer 62 also has at least two flexible coupling-locating apertures 64 . In the illustrated embodiment, there are four apertures 64 circumferentially arranged about the aperture 62 . In the illustrated embodiment, each of the apertures 64 has a diameter of about 1.0 mm. Each of the apertures 64 have beveled edges, above and below, while the aperture 62 has beveled edges above.
- the washer 60 also has a substantially centrally located bone screw-retaining aperture 62 .
- the aperture 62 has a diameter of about 4.6 mm and the washer 60 is adapted to allow mobile positioning against an arcuate undersurface 69 of the head of the bone screw 68 (illustrated in FIG. 5 b ).
- the washer 60 of the fourth aspect of the present invention is provided with a screw-retaining aperture 62 and at least two flexible coupling-locating apertures 64 which are preferably countersunk so as to allow easier threading passage of the flexible coupling 70 (not shown in FIGS. 5-5 b ). Care needs to be taken in such countersinking, to avoid compromising the mechanical strength of the apertures 62 , 64 of the washer 60 .
- FIG. 6 illustrates the implant apparatus used for fixation of the AC joint dislocation.
- the button 50 and the washer 60 are secured or pre-threaded together by means of a flexible coupling in the form of first suture 70 , preferably of number 5-strength braided polyester, which is double looped through the first and second apertures 52 , 54 of the button 50 and the peripheral apertures 64 of the washer 60 , as will now be described in greater detail.
- the first suture 70 is fed through to aperture 64 a of the washer 60 ; through the second and first apertures 54 , 52 of the button 50 ; through the aperture 64 b , under the washer 60 and back out the aperture 64 c ; through the second and first apertures 54 , 52 of the button 50 again; and finally through the aperture 64 d of the washer 60 .
- a needle 72 which may be straight or curved, with a second, pull-through suture 74 is also looped through either the first or second apertures 52 , 54 of the button 50 .
- the second suture 74 is looped through the first aperture 52 of the button 50 .
- the first suture 70 used in the apparatus can be made from any material which is suitable for this purpose, whether absorbable or non-absorbable, provided it is sufficiently strong.
- a number 5-strength braided polyester (FIBERWIRE®) suture is preferred. This is a non-absorbable suture which knots easily without slipping.
- the second suture 74 can be made from any material which is suitable for this purpose, and preferably should be at least 0-strength.
- the pull through needle 72 can be of any dimensions, provided it is long enough to span the clavicle 12 or the coracoid process 14 of the shoulder 10 .
- the needle 72 is preferably about 100 mm in length.
- the needle's body can either be straight or curved.
- the needle's tip can be either “taper cut” or “cutting.”
- leading and trailing edges of the button 50 are substantially symmetrical, although it will be appreciated that this is not a requirement of the present invention.
- the leading edge 56 (illustrated in FIG. 6 ) of the button 50 should be blunt and should have a width sufficient to reduce the possibility that the leading edge 56 of the button 50 follows the second or pull-through suture 74 through the intact skin or to catch or skewer any soft tissue structures between the bone and the skin, as will be described in detail hereinafter.
- FIG. 6 also illustrates a bone screw 68 as part of the implant apparatus.
- the bone screw 68 is used for engaging the washer 60 with the coracoid process 14 ( FIG. 7 f ).
- the bone screw 68 has an arcuate undersurface 69 for defining the movement of the washer 60 between the coracoid process 14 and the arcuate undersurface 69 .
- Button 50 overall 10.0 mm (length) ⁇ 3.5 mm (width) ⁇ 1.5 mm dimensions: (thickness)
- Basic shape Oblong in plan shape, with chamfered or rounded corners and edges - this reduces the chance of the button 50 being palpated under the skin and, in addition, eases the passage of the button 50 through a drill hole as will be explained hereinafter.
- Button 50 material Preferably titanium or stainless steel Button apertures 52, 54: Two apertures 52, 54 (oblong in plan shape) Apertures 52, 54 2 mm height ⁇ 3 mm length (oblong with dimensions: chamfered edges), preferably 1 mm distance between first and second apertures Suture 70 (first suture): Number 5-strength braided polyester suture, looped twice through the first and second apertures 52, 54 of the button 50 and each of the four peripheral apertures 64 (64a, 64b, 64c, 64d) of the washer 60, leaving the two free ends of suture 70 free for tying adjacent the undersurface of the washer 60.
- first suture Number 5-strength braided polyester suture
- Pull-through needle 72 100 mm long straight, or curved, needle 72 with pull-through, or second suture 74 attached.
- Pull-through suture 74 Minimum 0-strength suture 74 looped through the aperture 52 of the button 50, second suture 74 being secured to needle 72.
- the patient is positioned in a “deck-chair” position on the operating table (not shown).
- a sandbag (not shown) can be placed under the scapula to ease access to the shoulder region.
- a longitudinal or horizontal incision of about 5 cm is made on the skin, at the front of the shoulder, overlying the coracoid process 14 and the clavicle 12 .
- the clavicle 12 and the superior surface of the coracoid process 14 are exposed by blunt dissection.
- the clavicle hole 80 is to be drilled ( FIG. 7 a ) from above and substantially downwardly through the clavicle 12 , it will also be necessary to retract the skin about the clavicle 12 , in order to expose the superior surface 33 of the clavicle 12 .
- a 3.5 mm drill bit is required for drilling a hole 80 through the clavicle 12 .
- a 2.5 mm drill bit is required for drilling a hole 82 into the base of the coracoid process 14 of the scapula ( FIG. 7 a ). It is not necessary that the drill holes 80 , 82 be aligned with each other. In addition, it is not necessary, when the coracoclavicular interspace is reduced to normal, that the longitudinal axes of the respective drill holes 80 , 82 be co-linear or even substantially parallel with each other.
- the long straight needle 72 with pull-through, second suture 74 is passed upwards through the 3.5 mm drill hole 80 in the clavicle 12 and can be passed through the intact skin on the superior aspect of the clavicle 12 or through the open surgical wound.
- the pull-through suture 74 which engages the first aperture 52 (not shown) of the button 50 , can now advance the button 50 , substantially longitudinally through the drill hole 80 . Engagement of the second suture 74 in the aperture 52 (not shown) ensures that the second suture 74 is located adjacent the longitudinal mid-line of the button 50 so that the second suture 74 stays central in the first aperture 52 .
- FIG. 7 d once the button 50 has exited the superior surface 33 of the clavicle 12 , the angle of traction on the pull-through, or second, suture 74 is changed and counter-traction is exerted on the first suture 70 , in order to flip (pivot) the button 50 and engage the button 50 against the superior surface 33 of the clavicle 12 .
- the pull-through, or second, suture 74 can be cut and removed ( FIGS. 7 d and 7 e ).
- FIG. 7 f the screw 68 containing the washer 60 is inserted into the 2.5 mm drill hole 82 ( FIG. 7 e ) in the base of the coracoid process 14 of the scapula.
- the acromioclavicular joint 34 is reduced by downward manual pressure on the lateral end 20 of the clavicle 12 ( FIGS. 7 e and 7 f ).
- the two trailing ends of the first suture 70 are pulled to approximate the desired distance between the button 50 and the washer 60 , and hence reduce the interval between the clavicle 12 and the coracoid process 14 .
- the first suture 70 is then secured to itself with a knot, tied tight by hand.
- the free ends of the first suture 70 can then be cut approximately 1 cm long, to avoid knot slippage.
- the screw 68 can then be fully seated into the drill hole 82 in the coracoid process 14 to maximize suture tension, or may be advanced or retracted accordingly to fine tune the suture tension, according to the surgeon's preference.
- the volume between the arcuate undersurface 69 of the bone screw 68 and the coracoid process 14 defines the maximum flexibility of the washer 60 therebetween.
- the designed flexibility is helpful in increasing the tolerance for non-aligned drill holes and the like.
- the shoulder should be placed in a shoulder immobilizer for three weeks.
- gentle range of motion exercises can begin after three weeks.
- Full range exercises can be allowed after six weeks.
- Routine removal of the first suture anchor-suture-second suture anchor construct is not required. If, for any reason, it needs to be removed, this can be performed simply by re-opening the surgical incision, cutting the first suture 70 as it loops through the button 50 and removing the button 50 .
- the screw 68 and washer 60 can be removed easily using the screwdriver.
Abstract
An apparatus and method for surgically reducing and internally fixing a shoulder acromioclavicular joint dislocation are disclosed. The apparatus preferably comprises a button and a washer, the washer being flexibly secured to the coracoid process of the scapula by means of a bone screw, the button and washer being secured together by means of a first suture. A second suture is provided secured between the button and a needle, such that the needle and associated button, may be advanced through a hole drilled through the clavicle, wherein the button and the washer may then be tightened, reducing the coracoclavicular distance, by means of the first suture connected therebetween, to reduce and hold a desired acromioclavicular joint dislocation.
Description
- This application claims the benefit of U.S. Provisional Application Ser. No. 60/697,125 filed on Jul. 7, 2005, the entire disclosure of which is incorporated herein by reference.
- The present invention relates to an apparatus and a method for internal fixation of an acromioclavicular joint dislocation of the shoulder with resultant superior migration of the lateral end of the clavicle with respect to the acromium and the coracoid of the scapula.
- Acromioclavicular (“AC”) joint dislocations are characterized by severe upward displacement of the lateral end of the clavicle relative to the acromium of the scapula. Surgery is recommended to reduce and internally fix the displacement, which could otherwise lead to a painful deformity and loss of function.
- This invention relates to reconstruction surgery and particularly to reconstruction surgery for Rockwood types II-VI AC joint dislocations of the shoulder (Rockwood, Williams, & Young, Injuries to the Acromioclavicular Joints, in FRACTURES IN ADULTS 1341-1413 (Rockwood & Green, eds., 3rd ed., 1996)). More particularly, the invention relates to the use of a first suture anchor-suture-second suture anchor technique to reduce and internally fix the dislocation between the clavicle and the coracoid process.
- Injuries to the AC joint are generally classified as types I-VI, depending on the type and amount of disruption to the AC and the coracoclavicular ligaments. A type III AC dislocation of the shoulder is a common injury that occurs primarily from having a fall to the point of the shoulder. A type III injury is characterized by disruption of the AC and coracoclavicular ligaments, the dislocation of the AC joint and the upward relative displacement of the lateral end of the clavicle. The coracoclavicular interspace is greater than in the normal shoulder.
- There are presently two basic treatment options available: non-operative treatments and operative procedures.
- The non-operative option includes external, closed reduction. Various external, closed reduction procedures have been tried in the past using straps, casts, and different taping techniques. Generally, it has been believed that the procedures would work if applied continuously. Unfortunately, it has been found not to work as no one can wear them continuously because of skin breakdown and discomfort. As a result, such treatment regimes rarely have been successful. The patient must inevitably accept a cosmetic deformity and suffer from pain and fatigue after prolonged physical activity or heavy lifting.
- Operative treatments to date have focused on open reduction and direct repair or reconstruction of the ligaments. This procedure corrects the deformity and is generally accepted as providing the best results. However, this usually entails an extensive open operation. The deltoid and trapezius muscles are taken off the clavicle and dissected to expose the underside of the clavicle and the coracoclavicular ligaments and the coracoid process. The procedure requires an in-hospital stay, extended time for the surgical wound to heal, and rehabilitation. The open reduction procedure is generally recommended as the treatment of choice for people involved in heavy lifting work or active athletics. The remaining population is generally told to accept the deformity and to accept the pain and fatigue after heavy lifting or activity.
- It is well-known in the art to fix the coracoclavicular space by drilling a hole through the clavicle and into the coracoid process and by then inserting a screw (a Bosworth screw, for example) therebetween. It is also well-known to loop a flexible coupling such as a nylon tape around both the coracoid and the clavicle and to knot them together. This has the disadvantage of requiring that all of the coracoid be exposed. It is also known to drill a hole in the coracoid process and attach a single suture anchor, with a pair of sutures extending therefrom, into the coracoid. The free ends of the sutures are then looped about the clavicle and tied to each other.
- Non-operative treatment options generally provide unacceptable results. The open reduction treatment, while providing generally good results, has the disadvantage of an in-hospital stay plus the extensive time required for healing and rehabilitation. A surgical outpatient technique that would correct the deformity and allow healing of the injury in a normal anatomic position without extensive tissue dissection and less scarring would provide a substantial improvement over current treatment methods.
- It is an object of the present invention to overcome the problems associated with the prior art, whilst permitting normal physiological movement of the clavicle relative to the coracoid.
- The present invention relates to a surprising use of a first suture anchor-suture-second suture anchor technique. The proposed method of the present invention is simple and is performed by a mini-open approach.
- In a first aspect of the present invention there is provided an apparatus for use in internal fixation of AC joint dislocations of a shoulder. The apparatus of the first aspect of the present invention is a kit of parts for internal fixation of an AC joint dislocation of a shoulder, the shoulder including a clavicle, a coracoid process and an acromium, the kit of parts comprising a first suture anchor; a second suture anchor, the first and second suture anchors being adapted for engagement in or on the clavicle and the coracoid process, respectively; a flexible coupling mountable, in use, between the first and second suture anchors; and a needle releasably securable to at least one of the first and second suture anchors, in which the first and second suture anchors each have at least first and second apertures and the flexible coupling is a first suture which is double looped through the first and second suture anchors.
- Preferably, the first suture is fed, in use, through a first aperture of the second suture anchor, and through, in turn, the second and first apertures of the first suture anchor and through, in turn, second and first apertures of the second suture anchor, and through, in turn, the second and first apertures of the first suture anchor and through the second aperture of the second suture anchor.
- Preferably, the first suture anchor comprises a button and the second suture anchor comprises a washer, the washer being adapted and dimensioned to engage with a bone anchor. Alternatively, each of the first and second suture anchors can be a button. In another embodiment, each of the first and second suture anchors can be a washer, the washer being adapted and dimensioned to engage with a bone anchor. In yet another embodiment, the first suture anchor is a washer and the second suture anchor is a button. The bone anchor may be a bone screw, a bone nail, a bone staple or an intraosseous bone anchor. A bone screw is preferred. Even more preferably, the washer has a central aperture and at least two, preferably at least four, peripheral apertures, the central aperture being adapted and dimensioned to accept a bone screw.
- More preferably, the first suture anchor is a button having an oblong body and first and second apertures and the second suture anchor is a washer adapted to engage with a bone anchor and having at least two, preferably at least four, peripheral apertures. In this embodiment, the first suture is fed through a first peripheral aperture of the washer and through, in turn, the second and first apertures of the button and through, in turn, second and third peripheral apertures of the washer, and through, in turn, the second and first apertures of the button and through the fourth peripheral aperture of the washer. A loop is formed on the underneath of the washer, by the path of the first suture between the second and third peripheral apertures. If desired, the free ends of the first suture may be fed under this loop, to provide a self-tightening suture.
- When one or both of the suture anchors is a button, the needle is preferably secured to one or both of the first and second buttons by means of a second suture looped through one of the first or second apertures of the first and/or second buttons, the second suture being operatively associated with the needle.
- In a second aspect of the present invention there is provided a method for internal fixation of AC joint dislocations. The method of the present invention comprises the steps of providing an apparatus according to the first aspect of the present invention; securing the first and second suture anchors on or adjacent the clavicle and the coracoid process, respectively; and reducing and fixing the distance between the clavicle and the coracoid process, by traction of the flexible coupling.
- When the apparatus of the first aspect of the invention comprises a button as the first suture anchor and a washer as the second suture anchor, the method preferably comprises the steps of drilling a clavicle hole through the clavicle and a coracoid hole into the coracoid process; passing the needle through the clavicle hole, so as to advance the button longitudinally through the clavicle hole; pivoting the button so as to engage the button against a superior surface of the clavicle; inserting a screw through a central aperture of the washer into the coracoid hole in a superior aspect of the coracoid process; and reducing and fixing the distance between the clavicle and the coracoid process, by traction of the flexible coupling. Preferably, the needle is uncoupled from the button when the button has been advanced through the clavicle hole and has engaged against the superior surface of the clavicle.
- It will be appreciated by those skilled in the art that traction of the flexible coupling can be effected by hand traction or by the use of a suture tensioner. Suitable suture tensioners are well known in the art.
- In a third aspect of the present invention there is provided a button for use in the apparatus of the first aspect of the invention and for use in the method of the second aspect of the present invention. The button of the third aspect of the invention can be used as either the first or second suture anchor or as each of the first and second suture anchors. The button of the third aspect of the present invention may comprise an oblong body defining first and second apertures. Preferably, each of the first and second apertures is oblong, their longitudinal mid-lines being located substantially about a longitudinal mid-line of the oblong body.
- Alternatively, each of the first and second apertures is substantially triangular in plan view. In this alternative embodiment, each aperture is tapered and terminates in an apex, the apices being directed away from each other. Preferably, each of the apertures comprises first, second and third walls and the first walls of the respective first and second apertures are substantially parallel.
- The button of the third aspect of the present invention may have any suitable dimension (width, length and thickness). If the button is oblong, for example, the button of the third aspect of the present invention can have a width of 2.5 mm to 4.0 mm without compromising implant strength, although a width of 3.0 mm to 4.0 mm is preferred. The length of the button of the third aspect of the present invention is less critical but may, for example, be in the range 7.5 mm to 12.5 mm. A length in the range 9 mm to 11 mm is preferred since the button of the third aspect of the present invention is then slightly less palpable under the skin following implantation.
- Each of the first and second apertures of the button of the third aspect of the present invention may have any shape or geometry. For example, one embodiment is an aperture which is substantially triangular in plan view. Another embodiment is an egg-shaped or oval aperture, the curved narrower end comprising the apex.
- In a fourth aspect of the present invention there is provided a washer for use in the apparatus of the first aspect of the invention and for use in the method of the second aspect of the present invention. The washer of the fourth aspect of the invention can be used as either the first or second suture anchor or as each of the first and second suture anchors. The washer of the fourth aspect of the present invention comprises a body adapted for engagement with a bone anchor and having at least two, preferably at least four, peripheral apertures. The washer of the fourth aspect of the present invention optionally comprises a disc-shaped body defining a central aperture shaped and dimensioned to accept a bone screw and having four peripheral apertures. Preferably, each of the central and peripheral apertures is circular in plan view.
- The washer of the fourth aspect of the present invention can have an external diameter of 6.5 mm to 13.0 mm and a thickness of 1.0 mm to 2.0 mm without compromising implant strength, although an external diameter of 8 mm to 12 mm and a thickness of about 1.5 mm is preferred. The central aperture of the washer of the fourth aspect of the present invention can have an internal diameter of 2.5 mm to 6.5 mm, although an internal diameter of 3.5 mm to 5.5 mm is preferred. In an optional embodiment, the four peripheral apertures of the washer of the fourth aspect of the present invention can have an internal diameter of 0.5 mm to 2.0 mm, although an internal diameter of 0.8 mm to 1.2 mm is preferred.
- As used herein, the term “button” or “washer” is intended to mean any suitably shaped and dimensioned suture anchor or stress bearing member which is capable of transmitting a force incident thereon to any body with which the button or washer is in contact.
- These and other features and advantages of the invention will be more apparent from the following detailed description that is provided in connection with the accompanying drawings and illustrated exemplary embodiments of the invention, in which:
-
FIGS. 1 and 1 a show an anterior view and a schematic view, respectively, of a normal acromioclavicular joint; -
FIGS. 2 and 2 a show an anterior view and a schematic view, respectively, of a Rockwood Type III acromioclavicular joint dislocation, with superior migration of the clavicle with respect to the acromium; -
FIG. 3 shows a plan view of a first or second suture anchor in the form of a button of the present invention; -
FIG. 4 shows perspective, plan and sectional view of an alternative embodiment of a button according to the invention; -
FIGS. 5 and 5 a show a plan and an undersurface view, respectively, of a first or second suture anchor in the form of a washer of the present invention; -
FIG. 5 b illustrates the mobile positioning of the washer against an arcuate undersurface of the screw-head of a bone anchor; -
FIG. 6 shows a perspective view of the kit of parts comprising an apparatus of the present invention; and -
FIGS. 7 a-7 f illustrate, in sequence, the steps of a method according to the present invention. - In the following detailed description, reference is made to the accompanying drawings, which form a part hereof and illustrate specific embodiments in which the invention may be practiced. In the drawings, like reference numerals describe substantially similar components throughout the several views. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that other embodiments may be utilized, and that structural, logical and electrical changes may be made without departing from the spirit and scope of the present invention.
- The present invention provides minimally invasive, flexible fixation of the AC joint dislocation by resisting superior migration of the clavicle with respect to the coracoid process. It allows physiological micromotion at the AC joint. There should be no need for routine removal of the implant.
- The present invention is indicated for use in the fixation of AC joint dislocation. These are typically seen in Rockwood type III AC joint dislocations, usually caused by severe downward blunt trauma to the point of the shoulder, or acromium. Typically, the clavicle is upwardly displaced as a result of the injury because of disruption to the AC and coracoclavicular ligaments. Reduction and fixation of displaced AC joint dislocations are necessary to prevent painful deformity and loss of function.
-
FIGS. 1 and 1 a show anterior and schematic views of anormal shoulder 10.FIGS. 2 and 2 a show anterior and schematic views of ashoulder 10 that has suffered a Rockwood type III AC joint dislocation injury. - Referring to
FIGS. 1 and 2 , the structure of ashoulder 10 relevant to a Rockwood type III dislocation injury includes theclavicle 12, thecoracoid process 14 and theacromium 16. Theacromium 16 and theclavicle 12 are connected by theacromioclavicular ligament 18. Theacromioclavicular ligament 18 extends from thelateral end 20 of theclavicle 12 to themedial surface 22 of theacromium 16. Thecoracoid process 14 is connected to theclavicle 12 by thecoracoclavicular ligaments 24, which comprise thetrapezoid ligament 26 and theconoid ligament 28. Thecoracoclavicular ligaments 24 extend from theinferior surface 30 of theclavicle 12 to thesuperior surface 32 of thecoracoid process 14. - A Rockwood type III AC joint dislocation is characterized by the disruption of the AC and the
coracoclavicular ligaments FIGS. 2 and 2 a, theclavicle 12 separates from, and moves away from, thecoracoid process 14 and theacromium 16, accompanied by disruption of the coracoclavicular and theAC ligaments FIG. 2 ) is dislocated and theclavicle 12 is relatively displaced upwardly. The coraco-acromial ligament 36 (FIG. 1 ) is not impacted in the type III shoulder dislocation. - Repair of the type III shoulder dislocation according to the present invention is an out-patient procedure performed with a general anesthetic. The procedure is done with the patient lying supine on the operating table, preferably in the “deck-chair” position to allow the surgeon full access to the affected shoulder.
- Referring to
FIG. 3 , the apparatus of the present invention comprises a first or second suture anchor in the form of abutton 50, which, in the embodiment illustrated, is about 10.0 mm in length by about 3.5 mm in width. Thebutton 50 is preferably formed from titanium or stainless steel, although it will be appreciated that any other suitable material could be used, in particular any suitable bioabsorbable material. Thebutton 50 has afirst aperture 52 and asecond aperture 54 which, in the embodiment illustrated, are oblong in shape, the longitudinal mid-line of each of the first andsecond apertures button 50. - Referring to
FIG. 4 , there is illustrated an alternative first or second suture anchor, generally indicated as 150. In the illustrated alternative embodiment, thebutton 150 is about 9.0 mm in length by about 3.5 mm in width, with a thickness of about 1.5 mm. Thebutton 150 has first andsecond apertures apertures respective apices 155 being directed away from each other and being located substantially about a longitudinal mid-line of thebutton 150. - Reference is now made to
FIGS. 5 and 5 a which illustrate a first or second suture anchor in the form of awasher 60. In the illustrated embodiment, thewasher 60 has an external diameter of about 10.0 mm. While the illustrated washer is disc-shaped, the washer is not so limited. Thewasher 60 is preferably formed from titanium or stainless steel although, as will be appreciated by those skilled in the art, any other suitable material, in particular any suitable bioabsorbable materials, may be used. Thewasher 62 also has at least two flexible coupling-locatingapertures 64. In the illustrated embodiment, there are fourapertures 64 circumferentially arranged about theaperture 62. In the illustrated embodiment, each of theapertures 64 has a diameter of about 1.0 mm. Each of theapertures 64 have beveled edges, above and below, while theaperture 62 has beveled edges above. - The
washer 60 also has a substantially centrally located bone screw-retainingaperture 62. In the illustrated embodiment, theaperture 62 has a diameter of about 4.6 mm and thewasher 60 is adapted to allow mobile positioning against anarcuate undersurface 69 of the head of the bone screw 68 (illustrated inFIG. 5 b). - Referring to
FIGS. 5 and 5 a, thewasher 60 of the fourth aspect of the present invention is provided with a screw-retainingaperture 62 and at least two flexible coupling-locatingapertures 64 which are preferably countersunk so as to allow easier threading passage of the flexible coupling 70 (not shown inFIGS. 5-5 b). Care needs to be taken in such countersinking, to avoid compromising the mechanical strength of theapertures washer 60. -
FIG. 6 illustrates the implant apparatus used for fixation of the AC joint dislocation. Thebutton 50 and thewasher 60 are secured or pre-threaded together by means of a flexible coupling in the form offirst suture 70, preferably of number 5-strength braided polyester, which is double looped through the first andsecond apertures button 50 and theperipheral apertures 64 of thewasher 60, as will now be described in greater detail. Specifically, thefirst suture 70 is fed through toaperture 64 a of thewasher 60; through the second andfirst apertures button 50; through theaperture 64 b, under thewasher 60 and back out theaperture 64 c; through the second andfirst apertures button 50 again; and finally through theaperture 64 d of thewasher 60. Aneedle 72, which may be straight or curved, with a second, pull-throughsuture 74 is also looped through either the first orsecond apertures button 50. Thesecond suture 74 is looped through thefirst aperture 52 of thebutton 50. - The
first suture 70 used in the apparatus can be made from any material which is suitable for this purpose, whether absorbable or non-absorbable, provided it is sufficiently strong. A number 5-strength braided polyester (FIBERWIRE®) suture is preferred. This is a non-absorbable suture which knots easily without slipping. Thesecond suture 74 can be made from any material which is suitable for this purpose, and preferably should be at least 0-strength. - The pull through
needle 72 can be of any dimensions, provided it is long enough to span theclavicle 12 or thecoracoid process 14 of theshoulder 10. Theneedle 72 is preferably about 100 mm in length. The needle's body can either be straight or curved. The needle's tip can be either “taper cut” or “cutting.” - In the present embodiment, leading and trailing edges of the
button 50 are substantially symmetrical, although it will be appreciated that this is not a requirement of the present invention. Specifically, the leading edge 56 (illustrated inFIG. 6 ) of thebutton 50 should be blunt and should have a width sufficient to reduce the possibility that the leadingedge 56 of thebutton 50 follows the second or pull-throughsuture 74 through the intact skin or to catch or skewer any soft tissue structures between the bone and the skin, as will be described in detail hereinafter. -
FIG. 6 also illustrates abone screw 68 as part of the implant apparatus. Thebone screw 68 is used for engaging thewasher 60 with the coracoid process 14 (FIG. 7 f). As discussed below in detail and with reference toFIG. 5 b, thebone screw 68 has anarcuate undersurface 69 for defining the movement of thewasher 60 between thecoracoid process 14 and thearcuate undersurface 69.TABLE 1 Apparatus/Button of FIGS. 3 and 6 Button 50 overall10.0 mm (length) × 3.5 mm (width) × 1.5 mm dimensions: (thickness) Basic shape: Oblong in plan shape, with chamfered or rounded corners and edges - this reduces the chance of the button 50 being palpatedunder the skin and, in addition, eases the passage of the button 50 through a drill holeas will be explained hereinafter. Button 50 material:Preferably titanium or stainless steel Button apertures 52, 54: Two apertures 52, 54 (oblong in plan shape)Apertures 2 mm height × 3 mm length (oblong with dimensions: chamfered edges), preferably 1 mm distance between first and second apertures Suture 70 (first suture): Number 5-strength braided polyester suture, looped twice through the first and second apertures 52, 54 of the button 50 and each ofthe four peripheral apertures 64 (64a, 64b, 64c, 64d) of the washer 60, leaving the twofree ends of suture 70 free for tying adjacentthe undersurface of the washer 60.Pull-through needle 72: 100 mm long straight, or curved, needle 72with pull-through, or second suture 74attached. Pull-through suture 74: Minimum 0- strength suture 74 loopedthrough the aperture 52 of thebutton 50,second suture 74 being secured toneedle 72. - The following sets out the procedure, as shown in
FIGS. 7 a-7 f, to be followed for Rockwood Type III dislocations. Surgeons skilled in the art will appreciate the modifications that might be needed in addressing Rockwood Type II and IV-VI dislocations. - Set-up
- The patient is positioned in a “deck-chair” position on the operating table (not shown). A sandbag (not shown) can be placed under the scapula to ease access to the shoulder region. A longitudinal or horizontal incision of about 5 cm is made on the skin, at the front of the shoulder, overlying the
coracoid process 14 and theclavicle 12. Theclavicle 12 and the superior surface of thecoracoid process 14 are exposed by blunt dissection. As explained in detail below, if theclavicle hole 80 is to be drilled (FIG. 7 a) from above and substantially downwardly through theclavicle 12, it will also be necessary to retract the skin about theclavicle 12, in order to expose thesuperior surface 33 of theclavicle 12. - Instrumentation
- A 3.5 mm drill bit is required for drilling a
hole 80 through theclavicle 12. A 2.5 mm drill bit is required for drilling ahole 82 into the base of thecoracoid process 14 of the scapula (FIG. 7 a). It is not necessary that the drill holes 80, 82 be aligned with each other. In addition, it is not necessary, when the coracoclavicular interspace is reduced to normal, that the longitudinal axes of the respective drill holes 80, 82 be co-linear or even substantially parallel with each other. - Button Placement
- As illustrated in
FIG. 7 b, the longstraight needle 72 with pull-through,second suture 74 is passed upwards through the 3.5mm drill hole 80 in theclavicle 12 and can be passed through the intact skin on the superior aspect of theclavicle 12 or through the open surgical wound. InFIG. 7 c, the pull-throughsuture 74, which engages the first aperture 52 (not shown) of thebutton 50, can now advance thebutton 50, substantially longitudinally through thedrill hole 80. Engagement of thesecond suture 74 in the aperture 52 (not shown) ensures that thesecond suture 74 is located adjacent the longitudinal mid-line of thebutton 50 so that thesecond suture 74 stays central in thefirst aperture 52. - In
FIG. 7 d, once thebutton 50 has exited thesuperior surface 33 of theclavicle 12, the angle of traction on the pull-through, or second,suture 74 is changed and counter-traction is exerted on thefirst suture 70, in order to flip (pivot) thebutton 50 and engage thebutton 50 against thesuperior surface 33 of theclavicle 12. Once thebutton 50 is anchored, the pull-through, or second,suture 74 can be cut and removed (FIGS. 7 d and 7 e). InFIG. 7 f, thescrew 68 containing thewasher 60 is inserted into the 2.5 mm drill hole 82 (FIG. 7 e) in the base of thecoracoid process 14 of the scapula. Before thewasher 60/bone screw 68 is fully seated into thedrill hole 82, the acromioclavicular joint 34 is reduced by downward manual pressure on thelateral end 20 of the clavicle 12 (FIGS. 7 e and 7 f). - The two trailing ends of the first suture 70 (
FIG. 7 e) are pulled to approximate the desired distance between thebutton 50 and thewasher 60, and hence reduce the interval between theclavicle 12 and thecoracoid process 14. Thefirst suture 70 is then secured to itself with a knot, tied tight by hand. The free ends of thefirst suture 70 can then be cut approximately 1 cm long, to avoid knot slippage. Thescrew 68 can then be fully seated into thedrill hole 82 in thecoracoid process 14 to maximize suture tension, or may be advanced or retracted accordingly to fine tune the suture tension, according to the surgeon's preference. - The volume between the
arcuate undersurface 69 of thebone screw 68 and thecoracoid process 14 defines the maximum flexibility of thewasher 60 therebetween. The designed flexibility is helpful in increasing the tolerance for non-aligned drill holes and the like. - Post-Operative Management
- Following wound closure, the shoulder should be placed in a shoulder immobilizer for three weeks. Gentle range of motion exercises can begin after three weeks. Full range exercises can be allowed after six weeks.
- Implant Removal
- Routine removal of the first suture anchor-suture-second suture anchor construct is not required. If, for any reason, it needs to be removed, this can be performed simply by re-opening the surgical incision, cutting the
first suture 70 as it loops through thebutton 50 and removing thebutton 50. Thescrew 68 andwasher 60 can be removed easily using the screwdriver. - It is noted that the above description and drawings are exemplary and illustrate preferred embodiments that achieve the objects, features and advantages of the present invention. It is not intended that the present invention be limited to the illustrated embodiments. Any modification of the present invention which comes within the spirit and scope of the following claims should be considered part of the present invention.
Claims (19)
1. An apparatus for use in internal fixation of acromioclavicular joint dislocations of a shoulder, the shoulder including a clavicle, a coracoid process and an acromium, the apparatus comprising:
a first suture anchor;
a second suture anchor, the first and second suture anchors being adapted for engagement in or on the clavicle and the coracoid process, respectively;
a flexible coupling mountable, in use, between the first and second suture anchors; and
a needle releasably securable to at least one of the first and second suture anchors, in which the first and second suture anchors each have at least first and second apertures and the flexible coupling is a first suture which is double looped through the first and second suture anchors.
2. The apparatus according to claim 1 , in which the flexible coupling is a first suture which is fed, in use, through a first aperture of the second suture anchor, and through, in turn, the second and first apertures of the first suture anchor and through, in turn, second and first apertures of the second suture anchor, and through, in turn the second and first apertures of the first suture anchor and through the second aperture of the second suture anchor.
3. The apparatus according to claim 1 , in which the needle is secured to at least one of the first and second suture anchors by means of a second suture looped through one of the first or second apertures of at least one of the first and second suture anchors and operatively associated with the needle.
4. The apparatus according to claim 1 , in which the first suture anchor comprises a button and the second suture anchor comprises a washer, the washer being adapted and dimensioned to engage with a bone anchor.
5. The apparatus according to claim 1 , in which the first suture anchor is a button having an oblong body and first and second apertures and the second suture anchor is a washer adapted to engage with a bone anchor and having at least two, preferably at least four, peripheral apertures.
6. The apparatus according to claim 5 , in which the first suture is fed through a first peripheral aperture of the washer and through, in turn, the second and first apertures of the button and through, in turn, second and third peripheral apertures of the washer, and through, in turn the second and first apertures of the button and through the fourth peripheral aperture of the washer.
7. A method for internal fixation of acromioclavicular joint dislocations, the method comprises the steps of:
providing an apparatus comprising: a first member; a second member, the first and second members being adapted for engagement in or on the clavicle and the coracoid process, respectively; and a flexible coupling between the first and second members, the flexible coupling comprising a suture strand which is double looped through the first and second members;
securing the first and second members on or adjacent the clavicle and the coracoid process, respectively; and
reducing and fixing the distance between the clavicle and the coracoid process.
8. The method according to claim 7 , wherein the method comprises: drilling holes through the clavicle and into the coracoid process; passing the needle through the clavicle hole, so as to advance the button longitudinally through the clavicle hole; pivoting the button so as to engage the button against a superior surface of the clavicle; inserting a screw through a central aperture of the washer into the coracoid hole in a superior aspect of the coracoid process; and reducing and fixing the distance between the clavicle and the coracoid process, by traction of the flexible coupling.
9. The method according to claim 7 , in which the reducing step is carried out before the securing step.
10. The method according to claim 8 , in which the needle is uncoupled from the button, when the button has been advanced through the hole.
11. A button for use in the method according to claim 7 , in which the button comprises an oblong body defining first and second apertures, each of the apertures being oblong, the longitudinal mid-line of the respective apertures being located substantially about a longitudinal mid-line of the oblong body.
12. The button according to claim 11 , in which the button has a width in the range of about 2.5 mm to about 4.0 mm.
13. The button according to claim 11 , in which the button has a width in the range of about 3.25 mm to about 4.0 mm.
14. The button according to claim 11 , in which the button has a length in the range of about 7.5 mm to about 12.5 mm.
15. The button according to claim 11 , in which the button has a length in the range of about 9 mm to about 11 mm.
16. A washer for use in the method according to claim 7 , in which the washer comprises a body adapted for engagement with a bone anchor and having at least two peripheral apertures.
17. The washer according to claim 16 in which the bone anchor is a bone screw and the body defines at least one screw-retaining aperture and has at least four peripheral apertures.
18. The washer according to claim 16 , in which the washer has a diameter in the range of 8 mm to 14 mm.
19. An apparatus for use in internal fixation of acromioclavicular joint dislocations of a shoulder, the shoulder including a clavicle, a coracoid process and an acromium, the apparatus comprising:
a first member;
a second member, the first and second members being adapted for engagement in or on the clavicle and the coracoid, respectively; and
a flexible coupling between the first and second members, the flexible coupling comprising a suture strand which is double looped through the first and second members.
Priority Applications (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/482,038 US8512376B2 (en) | 2002-08-30 | 2006-07-07 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US11/687,882 US9005245B2 (en) | 2002-08-30 | 2007-03-19 | Acromioclavicular joint fixation technique |
US13/027,700 US9072510B2 (en) | 2001-08-30 | 2011-02-15 | Acromioclavicular joint fixation technique |
US13/970,269 US20130331886A1 (en) | 2002-06-20 | 2013-08-19 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US14/933,269 US10206670B2 (en) | 2002-06-20 | 2015-11-05 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US15/483,338 US10390816B2 (en) | 2002-06-20 | 2017-04-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/542,565 US10695049B2 (en) | 2002-06-20 | 2019-08-16 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/794,494 US10736622B2 (en) | 2002-06-20 | 2020-02-19 | Apparatuses and method for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/988,823 US10918375B2 (en) | 2002-06-20 | 2020-08-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US17/172,473 US20210161518A1 (en) | 2002-06-20 | 2021-02-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/233,122 US7235091B2 (en) | 2002-06-20 | 2002-08-30 | Apparatus and method for fixation of ankle syndesmosis |
US69712505P | 2005-07-07 | 2005-07-07 | |
US11/482,038 US8512376B2 (en) | 2002-08-30 | 2006-07-07 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
Related Parent Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US23312201A Continuation-In-Part | 2001-08-30 | 2001-08-30 | |
US10/233,122 Continuation-In-Part US7235091B2 (en) | 2001-08-30 | 2002-08-30 | Apparatus and method for fixation of ankle syndesmosis |
Related Child Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/687,882 Continuation-In-Part US9005245B2 (en) | 2001-08-30 | 2007-03-19 | Acromioclavicular joint fixation technique |
US13/970,269 Division US20130331886A1 (en) | 2002-06-20 | 2013-08-19 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
Publications (2)
Publication Number | Publication Date |
---|---|
US20070016208A1 true US20070016208A1 (en) | 2007-01-18 |
US8512376B2 US8512376B2 (en) | 2013-08-20 |
Family
ID=37662606
Family Applications (8)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/482,038 Active 2027-09-12 US8512376B2 (en) | 2001-08-30 | 2006-07-07 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US13/970,269 Abandoned US20130331886A1 (en) | 2002-06-20 | 2013-08-19 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US14/933,269 Expired - Lifetime US10206670B2 (en) | 2002-06-20 | 2015-11-05 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US15/483,338 Expired - Fee Related US10390816B2 (en) | 2002-06-20 | 2017-04-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/542,565 Expired - Lifetime US10695049B2 (en) | 2002-06-20 | 2019-08-16 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/794,494 Expired - Lifetime US10736622B2 (en) | 2002-06-20 | 2020-02-19 | Apparatuses and method for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/988,823 Expired - Lifetime US10918375B2 (en) | 2002-06-20 | 2020-08-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US17/172,473 Abandoned US20210161518A1 (en) | 2002-06-20 | 2021-02-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
Family Applications After (7)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/970,269 Abandoned US20130331886A1 (en) | 2002-06-20 | 2013-08-19 | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US14/933,269 Expired - Lifetime US10206670B2 (en) | 2002-06-20 | 2015-11-05 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US15/483,338 Expired - Fee Related US10390816B2 (en) | 2002-06-20 | 2017-04-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/542,565 Expired - Lifetime US10695049B2 (en) | 2002-06-20 | 2019-08-16 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/794,494 Expired - Lifetime US10736622B2 (en) | 2002-06-20 | 2020-02-19 | Apparatuses and method for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US16/988,823 Expired - Lifetime US10918375B2 (en) | 2002-06-20 | 2020-08-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
US17/172,473 Abandoned US20210161518A1 (en) | 2002-06-20 | 2021-02-10 | Apparatuses and methods for fixation of ankle syndesmosis or acromioclavicular joint dislocations of the shoulder |
Country Status (1)
Country | Link |
---|---|
US (8) | US8512376B2 (en) |
Cited By (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20070179531A1 (en) * | 2002-08-30 | 2007-08-02 | Brian Thornes | Acromioclavicular joint fixation technique |
US20070219558A1 (en) * | 2006-03-15 | 2007-09-20 | Allen Deutsch | Method and apparatus for arthroscopic surgery using suture anchors |
EP1958591A2 (en) | 2007-02-13 | 2008-08-20 | Arthrex, Inc. | Intraarticular graft length gauge |
US20090099556A1 (en) * | 2007-02-13 | 2009-04-16 | Ricardo Albertorio | Tunnel measuring device for ligament reconstruction |
US20090182335A1 (en) * | 2007-11-05 | 2009-07-16 | Steven Struhl | Device for treatment of acromioclavicular joint dislocations |
US20100082045A1 (en) * | 2008-09-29 | 2010-04-01 | Wolf Petersen | Flipp tack pusher |
WO2011040917A1 (en) * | 2009-09-30 | 2011-04-07 | Strathmore Industries Inc. | Apparatus and method for a suture button |
US8840644B2 (en) | 2011-03-24 | 2014-09-23 | Howmedica Osteonics Corp. | Toggle bolt suture anchor |
US8926661B2 (en) | 2011-06-02 | 2015-01-06 | Smith & Nephew, Inc. | Surgical fastening |
US20150164498A1 (en) * | 2013-12-11 | 2015-06-18 | Arthrex, Inc. | Suture washer |
US9060824B2 (en) | 2011-11-17 | 2015-06-23 | Metal Industries Research & Development Centre | Bone screw, method for manufacturing the bone screw, and tool for mounting and removing the bone screw |
US9072509B2 (en) | 2007-10-12 | 2015-07-07 | Howmedica Osteonics Corp. | Toggle bolt suture anchor kit |
US9138219B2 (en) | 2010-12-29 | 2015-09-22 | Tarsus Medical Inc. | Methods and devices for treating a syndesmosis injury |
US20160089131A1 (en) * | 2014-09-26 | 2016-03-31 | Dallen Medical, Inc. | Implant devices and systems for stabilized fixation of bone and soft tissue |
RU2581496C1 (en) * | 2015-06-16 | 2016-04-20 | Федеральное государственное бюджетное военное образовательное учреждение высшего профессионального образования Военно-медицинская академия им. С.М. Кирова Министерства обороны Российской Федерации (ВМедА) | Method for surgical treatment of old and recurrent dislocations of sternal end of clavicle |
US20160166291A1 (en) * | 2013-06-24 | 2016-06-16 | The University Of Toledo | Bioactive Fusion Device |
US9421007B2 (en) | 2010-12-09 | 2016-08-23 | Arthrex, Inc. | Acromioclavicular joint fixation using suture button contstruct with dog bone-shaped button |
US20170156726A1 (en) * | 2012-01-24 | 2017-06-08 | DePuy Synthes Products, Inc. | Compression screw system |
US9713463B2 (en) | 2011-01-13 | 2017-07-25 | Howmedica Osteonics Corp | Toggle bolt assembly and method of assembly |
US10123813B2 (en) | 2014-02-17 | 2018-11-13 | Smith & Nephew, Inc. | Drill guide |
CN109646121A (en) * | 2019-02-15 | 2019-04-19 | 首都医科大学附属北京朝阳医院 | A kind of rotator cuff injury treatment gasket and its application method |
US10695096B2 (en) | 2013-04-16 | 2020-06-30 | Arthrosurface Incorporated | Suture system and method |
CN111658231A (en) * | 2020-07-10 | 2020-09-15 | 深圳市第二人民医院(深圳市转化医学研究院) | Fixing device for joint dislocation or ligament reconstruction |
US11123121B2 (en) | 2016-05-13 | 2021-09-21 | University Of Virginia Patent Foundation | Coracoclavicular fixation device and related method thereof |
WO2021195460A1 (en) * | 2020-03-27 | 2021-09-30 | Edwards Lifesciences Corporation | Suture tension distribution |
US11191552B2 (en) | 2012-07-03 | 2021-12-07 | Arthrosurface, Incorporated | System and method for joint resurfacing and repair |
US11317903B2 (en) * | 2014-09-26 | 2022-05-03 | Tensyn Medical, Inc. | Implant devices and systems for stabilized fixation of bone and soft tissue |
US11337819B2 (en) | 2003-02-24 | 2022-05-24 | Arthrosurface Incorporated | Trochlear resurfacing system and method |
US11471289B2 (en) | 2006-07-17 | 2022-10-18 | Arthrosurface Incorporated | Tibial resurfacing system and method |
US11478259B2 (en) | 2009-04-17 | 2022-10-25 | Arthrosurface, Incorporated | Glenoid resurfacing system and method |
US11478358B2 (en) | 2019-03-12 | 2022-10-25 | Arthrosurface Incorporated | Humeral and glenoid articular surface implant systems and methods |
US11607319B2 (en) | 2014-03-07 | 2023-03-21 | Arthrosurface Incorporated | System and method for repairing articular surfaces |
RU2798680C1 (en) * | 2022-11-24 | 2023-06-23 | федеральное государственное бюджетное образовательное учреждение высшего образования "Башкирский государственный медицинский университет" Министерства здравоохранения Российской Федерации | Surgical treatment of dislocations of the sternal end of the clavicle |
US11712276B2 (en) | 2011-12-22 | 2023-08-01 | Arthrosurface Incorporated | System and method for bone fixation |
US11766334B2 (en) | 2014-03-07 | 2023-09-26 | Arthrosurface Incorporated | System and method for repairing articular surfaces |
Families Citing this family (48)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8177841B2 (en) | 2000-05-01 | 2012-05-15 | Arthrosurface Inc. | System and method for joint resurface repair |
US6610067B2 (en) | 2000-05-01 | 2003-08-26 | Arthrosurface, Incorporated | System and method for joint resurface repair |
EP2314257B9 (en) | 2000-05-01 | 2013-02-27 | ArthroSurface, Inc. | System for joint resurface repair |
US8512376B2 (en) | 2002-08-30 | 2013-08-20 | Arthrex, Inc. | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
EP1845890A4 (en) | 2003-11-20 | 2010-06-09 | Arthrosurface Inc | System and method for retrograde procedure |
AU2004293042A1 (en) | 2003-11-20 | 2005-06-09 | Arthrosurface, Inc. | Retrograde delivery of resurfacing devices |
EP1765201A4 (en) | 2004-06-28 | 2013-01-23 | Arthrosurface Inc | System for articular surface replacement |
US7828853B2 (en) | 2004-11-22 | 2010-11-09 | Arthrosurface, Inc. | Articular surface implant and delivery system |
AU2007332787A1 (en) | 2006-12-11 | 2008-06-19 | Arthrosurface Incorporated | Retrograde resection apparatus and method |
EP2262448A4 (en) | 2008-03-03 | 2014-03-26 | Arthrosurface Inc | Bone resurfacing system and method |
US10278692B2 (en) | 2008-10-23 | 2019-05-07 | CMC Group LLC | Sling suspension system for supporting the thumb of a patient after basal joint arthroplasty |
US10945743B2 (en) | 2009-04-17 | 2021-03-16 | Arthrosurface Incorporated | Glenoid repair system and methods of use thereof |
CA3064646C (en) | 2009-04-17 | 2023-01-03 | Arthrosurface Incorporated | Glenoid resurfacing system and method |
EP2455002B1 (en) | 2010-11-17 | 2019-04-03 | Arthrex, Inc. | Adjustable suture-button construct for ankle syndesmosis repair |
US9066716B2 (en) | 2011-03-30 | 2015-06-30 | Arthrosurface Incorporated | Suture coil and suture sheath for tissue repair |
US8734491B2 (en) | 2011-08-24 | 2014-05-27 | Instratek, Inc. | Method and apparatus for the stabilization of the trapeziometacarpal joint |
US10052094B2 (en) | 2013-03-11 | 2018-08-21 | Medos International Sàrl | Implant having adjustable filament coils |
US9974643B2 (en) | 2013-03-11 | 2018-05-22 | Medos International Sàrl | Implant having adjustable filament coils |
US9757113B2 (en) | 2013-07-31 | 2017-09-12 | Medos International Sàrl | Adjustable graft fixation device |
US10405968B2 (en) | 2013-12-11 | 2019-09-10 | Medos International Sarl | Implant having filament limbs of an adjustable loop disposed in a shuttle suture |
US11484301B2 (en) | 2014-01-14 | 2022-11-01 | Simparo Inc. | Suture-locking washer for use with a bone anchor, and method for supporting the thumb of a patient after basal joint arthroplasty, and other novel orthopedic apparatus and other novel orthopedic procedures |
US10624748B2 (en) | 2014-03-07 | 2020-04-21 | Arthrosurface Incorporated | System and method for repairing articular surfaces |
US10751161B2 (en) | 2014-10-23 | 2020-08-25 | Medos International Sárl | Biceps tenodesis anchor implants |
US10076374B2 (en) | 2014-10-23 | 2018-09-18 | Medos International Sárl | Biceps tenodesis delivery tools |
US10856966B2 (en) | 2014-10-23 | 2020-12-08 | Medos International Sarl | Biceps tenodesis implants and delivery tools |
US10034742B2 (en) | 2014-10-23 | 2018-07-31 | Medos International Sarl | Biceps tenodesis implants and delivery tools |
US10729419B2 (en) | 2014-10-23 | 2020-08-04 | Medos International Sarl | Biceps tenodesis implants and delivery tools |
US9693856B2 (en) | 2015-04-22 | 2017-07-04 | DePuy Synthes Products, LLC | Biceps repair device |
US10426459B2 (en) | 2016-07-05 | 2019-10-01 | Mortise Medical, LLC | Extra joint stabilization construct |
CN108289663A (en) | 2015-10-08 | 2018-07-17 | 史密夫和内修有限公司 | Device and method for joint repair |
US10194899B2 (en) | 2015-10-28 | 2019-02-05 | Arthrex, Inc. | Systems and methods for acromioclavicular stabilization |
US10105169B2 (en) | 2015-11-13 | 2018-10-23 | Leith Medical LLC | Bone fixation systems, apparatuses, and methods with anti-back-out feature |
EP3383281B1 (en) | 2015-12-04 | 2024-01-24 | Crossroads Extremity Systems, LLC | Devices for anchoring tissue |
US10231824B2 (en) | 2016-04-08 | 2019-03-19 | Medos International Sárl | Tenodesis anchoring systems and tools |
US10231823B2 (en) | 2016-04-08 | 2019-03-19 | Medos International Sarl | Tenodesis implants and tools |
US11013506B2 (en) | 2017-11-01 | 2021-05-25 | Wright Medical Technology, Inc. | Partially assembled knotless suture construct |
CA3108761A1 (en) | 2017-08-04 | 2019-02-07 | Arthrosurface Incorporated | Multicomponent articular surface implant |
US11272967B2 (en) | 2018-07-11 | 2022-03-15 | Medline Industries, Lp | Bone plate system and method |
US11426205B2 (en) * | 2018-07-17 | 2022-08-30 | In2Bones Usa, Llc | Syndesmosis treatment construct |
US20220218327A1 (en) * | 2019-05-28 | 2022-07-14 | The General Hospital Corporation | Systems and methods for ankle syndesmosis repair |
US11426154B2 (en) | 2019-09-11 | 2022-08-30 | Medline Industries, Lp | Orthopedic stabilization device, kit, and method |
MX2022004471A (en) | 2019-10-14 | 2022-08-16 | Leith Medical LLC | Bone fixation system with fasteners and a removal tool for decoupling of the fasteners. |
RU195075U1 (en) * | 2019-11-08 | 2020-01-14 | Березкин Ярослав Вячеславович | Cortical anchor for flexible graft attachment in the bone tunnel |
WO2021091422A1 (en) * | 2019-11-08 | 2021-05-14 | БЕРЕЗКИН, Ярослав Вячеславович | Cortical anchor for flexibly securing a graft in a bone tunnel |
US11529134B2 (en) * | 2019-12-17 | 2022-12-20 | In2Bones Usa, Llc | Syndesmosis treatment construct |
US20210298740A1 (en) * | 2020-03-26 | 2021-09-30 | In2Bones Usa, Llc | Syndesmosis insertion construct |
CN113520556B (en) * | 2021-07-09 | 2022-04-22 | 北京天星博迈迪医疗器械有限公司 | Acromioclavicular joint repairing device |
US20240065686A1 (en) * | 2022-08-24 | 2024-02-29 | Globus Medical, Inc. | Systems, devices and methods for implanting suture buttons |
Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2765787A (en) * | 1954-08-02 | 1956-10-09 | Leon L Pellet | Hip arthroplasty with flexible securing means |
US4988351A (en) * | 1989-01-06 | 1991-01-29 | Concept, Inc. | Washer for use with cancellous screw for attaching soft tissue to bone |
US5211647A (en) * | 1992-02-19 | 1993-05-18 | Arthrex Inc. | Interference screw and cannulated sheath for endosteal fixation of ligaments |
US5219359A (en) * | 1990-09-18 | 1993-06-15 | Femcare Limited | Suture apparatus |
US5306290A (en) * | 1993-02-12 | 1994-04-26 | Mitek Surgical Products, Inc. | Suture button |
US5409490A (en) * | 1993-08-16 | 1995-04-25 | Depuy Inc. | Shoulder separation reconstruction |
US20030130694A1 (en) * | 1999-12-02 | 2003-07-10 | Ray Bojarski | Soft tissue attachment and repair |
US20040236373A1 (en) * | 2003-05-20 | 2004-11-25 | Anspach William E. | Surgical method for suturing tendons/ligaments to bones |
Family Cites Families (175)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3176316A (en) | 1963-01-07 | 1965-04-06 | Bruce R Bodell | Plastic prosthetic tendon |
US3762418A (en) * | 1972-05-17 | 1973-10-02 | W Wasson | Surgical suture |
US4187558A (en) | 1977-10-25 | 1980-02-12 | Cutter Laboratories, Inc. | Prosthetic ligament |
CA1112401A (en) | 1979-05-24 | 1981-11-17 | Roland Dore | Deformable high energy storage tension spring |
GB2084468B (en) | 1980-09-25 | 1984-06-06 | South African Inventions | Surgical implant |
US4400833A (en) | 1981-06-10 | 1983-08-30 | Kurland Kenneth Z | Means and method of implanting bioprosthetics |
US4792336A (en) | 1986-03-03 | 1988-12-20 | American Cyanamid Company | Flat braided ligament or tendon implant device having texturized yarns |
US4731084A (en) | 1986-03-14 | 1988-03-15 | Richards Medical Company | Prosthetic ligament |
US4776851A (en) | 1986-07-23 | 1988-10-11 | Bruchman William C | Mechanical ligament |
GB8622563D0 (en) | 1986-09-19 | 1986-10-22 | Amis A A | Artificial ligaments |
CH671686A5 (en) | 1987-01-07 | 1989-09-29 | Sulzer Ag | |
US5263984A (en) | 1987-07-20 | 1993-11-23 | Regen Biologics, Inc. | Prosthetic ligaments |
US5026398A (en) | 1988-07-01 | 1991-06-25 | The Minnesota Mining And Manufacturing Company | Abrasion resistant prosthetic device |
US4917700A (en) | 1988-08-01 | 1990-04-17 | Zimmer, Inc. | Prosthetic ligament |
US5024669A (en) | 1988-09-09 | 1991-06-18 | Baxter International Inc. | Artificial ligament of differential weave structure |
US5217495A (en) | 1989-05-10 | 1993-06-08 | United States Surgical Corporation | Synthetic semiabsorbable composite yarn |
US5139520A (en) | 1990-01-31 | 1992-08-18 | American Cyanamid Company | Method for acl reconstruction |
US5129902A (en) | 1990-04-20 | 1992-07-14 | Marlowe Goble E | Endosteal ligament retainer and process |
EP0475889B1 (en) | 1990-09-07 | 1995-05-03 | SULZER Medizinaltechnik AG | Implant serving as ligament or tendon |
US5562669A (en) | 1994-01-13 | 1996-10-08 | Mcguire; David A. | Cruciate ligament reconstruction with tibial drill guide |
US5320626A (en) | 1992-02-19 | 1994-06-14 | Arthrex Inc. | Endoscopic drill guide |
US5266075A (en) | 1992-10-05 | 1993-11-30 | Roy Clark | Tendon threader for endosteal ligament mounting |
US5540703A (en) | 1993-01-06 | 1996-07-30 | Smith & Nephew Richards Inc. | Knotted cable attachment apparatus formed of braided polymeric fibers |
US5306301A (en) | 1993-02-11 | 1994-04-26 | American Cyanamid Company | Graft attachment device and method of using same |
US5397357A (en) | 1993-02-18 | 1995-03-14 | Arthrex, Inc. | Method for preparing a bone-tendon-bone core graft |
US5356413A (en) * | 1993-03-12 | 1994-10-18 | Mitek Surgical Products, Inc. | Surgical anchor and method for deploying the same |
US5632748A (en) | 1993-06-14 | 1997-05-27 | Linvatec Corporation | Endosteal anchoring device for urging a ligament against a bone surface |
US5643266A (en) | 1995-06-05 | 1997-07-01 | Li Medical Technologies, Inc. | Method and apparatus for securing ligaments |
DE19616122C1 (en) | 1996-04-23 | 1997-08-14 | Aesculap Ag | Implant for fixture of tendon replacement plastic in channel in knee area of tibia |
WO1998011839A1 (en) | 1996-09-20 | 1998-03-26 | Medicinelodge, Inc. | Adjustable length strap and footing for ligament mounting and method for its use |
GB9620046D0 (en) | 1996-09-26 | 1996-11-13 | Neoligaments | Attachment device for use in the implantation of prosthetic ligament |
US5830234A (en) * | 1997-04-04 | 1998-11-03 | Alto Development Corporation | Method for double wire sternotomy suture |
US5931869A (en) | 1997-07-23 | 1999-08-03 | Arthrotek, Inc. | Apparatus and method for tibial fixation of soft tissue |
US6159234A (en) | 1997-08-01 | 2000-12-12 | Peter M. Bonutti | Method and apparatus for securing a suture |
AUPP000797A0 (en) | 1997-10-24 | 1997-11-20 | Cryptych Pty Ltd | Fixation of cruciate ligament grafts |
US5921986A (en) | 1998-02-06 | 1999-07-13 | Bonutti; Peter M. | Bone suture |
US6045551A (en) | 1998-02-06 | 2000-04-04 | Bonutti; Peter M. | Bone suture |
US6099568A (en) | 1998-03-03 | 2000-08-08 | Linvatec Corporation | ACL graft fixation device and method |
US5964764A (en) | 1998-03-24 | 1999-10-12 | Hugh S. West, Jr. | Apparatus and methods for mounting a ligament graft to a bone |
US6099530A (en) | 1998-04-09 | 2000-08-08 | Smith & Nephew, Inc. | Soft-tissue intra-tunnel fixation device |
US6203572B1 (en) | 1999-02-09 | 2001-03-20 | Linvatec Corporation | Device and method for ligament reconstruction |
DE29910202U1 (en) | 1999-06-11 | 1999-08-05 | Aesculap Ag & Co Kg | Packing material for narrowing the cross section of a bone canal |
US6499486B1 (en) | 1999-07-29 | 2002-12-31 | Ethicon, Inc. | Method for reconstructing a ligament |
DE19941574A1 (en) | 1999-09-01 | 2001-03-08 | Storz Karl Gmbh & Co Kg | Instruments for implanting a tendon replacement |
US6737053B1 (en) | 1999-11-12 | 2004-05-18 | National University Of Singapore | Tissue-engineered ligament |
US20050070906A1 (en) | 1999-11-30 | 2005-03-31 | Ron Clark | Endosteal tibial ligament fixation with adjustable tensioning |
GB9929599D0 (en) | 1999-12-15 | 2000-02-09 | Atlantech Medical Devices Limi | A graft suspension device |
EP1272112A4 (en) | 2000-01-03 | 2003-05-14 | Yosef Freedland | Flip-wing tissue retainer |
US6893462B2 (en) | 2000-01-11 | 2005-05-17 | Regeneration Technologies, Inc. | Soft and calcified tissue implants |
US6635073B2 (en) | 2000-05-03 | 2003-10-21 | Peter M. Bonutti | Method of securing body tissue |
US6296659B1 (en) | 2000-02-29 | 2001-10-02 | Opus Medical, Inc. | Single-tailed suturing method and apparatus |
US7963966B2 (en) | 2000-06-06 | 2011-06-21 | Cole J Dean | Bone fixation system and method of use |
US6623524B2 (en) | 2000-06-09 | 2003-09-23 | Arthrex, Inc. | Method for anterior cruciate ligament reconstruction using cross-pin implant with eyelet |
US6325804B1 (en) | 2000-06-28 | 2001-12-04 | Ethicon, Inc. | Method for fixing a graft in a bone tunnel |
US6878166B2 (en) | 2000-08-28 | 2005-04-12 | Ron Clark | Method and implant for securing ligament replacement into the knee |
GB0024903D0 (en) | 2000-10-11 | 2000-11-22 | Ellis Dev Ltd | A textile prothesis |
US6641596B1 (en) * | 2000-10-18 | 2003-11-04 | Ethicon, Inc. | Knotless bioabsorbable suture anchor system and method |
DE10104658A1 (en) | 2001-02-02 | 2002-10-02 | Aesculap Ag & Co Kg | Implant for fixing a tendoplasty in a channel in the knee region of the tibia and/or femur comprises fixing the tendoplasty under tension in the channel by relative movement between a bearing element and a connecting element |
US6533802B2 (en) | 2001-05-16 | 2003-03-18 | Smith & Nephew, Inc. | Endobutton continuous loop for bone-tendon-bone |
US20050065533A1 (en) | 2001-05-31 | 2005-03-24 | Magen Hugh E. | Apparatus for assembling anterior cruciate ligament reconstruction system |
DE10129490A1 (en) * | 2001-06-21 | 2003-01-02 | Helmut Mueckter | Implantable screw for stabilization of joint or bone fracture, has flexible shaft which interconnects proximal head portion and distal insertion portion of elongated screw body |
US7235091B2 (en) | 2002-06-20 | 2007-06-26 | Brian Thornes | Apparatus and method for fixation of ankle syndesmosis |
US8512376B2 (en) * | 2002-08-30 | 2013-08-20 | Arthrex, Inc. | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
US9005245B2 (en) | 2002-08-30 | 2015-04-14 | Arthrex, Inc. | Acromioclavicular joint fixation technique |
US6716234B2 (en) | 2001-09-13 | 2004-04-06 | Arthrex, Inc. | High strength suture material |
US6887271B2 (en) | 2001-09-28 | 2005-05-03 | Ethicon, Inc. | Expanding ligament graft fixation system and method |
US6712849B2 (en) | 2001-10-01 | 2004-03-30 | Scandius Biomedical, Inc. | Apparatus and method for reconstructing a ligament |
US7520898B2 (en) | 2001-10-01 | 2009-04-21 | Scandius Biomedical, Inc. | Apparatus and method for reconstructing a ligament |
US6599319B2 (en) | 2001-12-14 | 2003-07-29 | Celanese Advanced Materials, Inc. | Prosthetic ligament |
AU2003207698A1 (en) * | 2002-01-26 | 2003-09-02 | Emory University | Needle-suture combinations and methods of use |
DE50200594D1 (en) | 2002-02-08 | 2004-08-12 | Storz Karl Gmbh & Co Kg | Anchor element for anchoring a ligament graft |
US6890354B2 (en) | 2002-03-08 | 2005-05-10 | Musculoskeletal Transplant Foundation | Bone-tendon-bone assembly with allograft bone block and method for inserting same |
EP1499256A4 (en) | 2002-04-12 | 2010-09-15 | Eric S Steenlage | Method and apparatus for reconstructing a ligament |
FR2847456B1 (en) | 2002-11-21 | 2005-01-28 | Michel Collette | SCREWS FOR FIXING A LIGAMENT GRAFT |
DE102004025332A1 (en) | 2003-05-26 | 2004-12-16 | Huber, Jakob, Dipl.-Ing. | Alloplastic ligament, in particular, in the form of a crucial ligament consist of a plastic material which is at least partially coated with an aluminum oxide ceramic, a zirconium oxide ceramic or tantalum |
US7722644B2 (en) | 2003-06-11 | 2010-05-25 | Medicine Lodge, Inc. | Compact line locks and methods |
US7326247B2 (en) | 2003-10-30 | 2008-02-05 | Arthrex, Inc. | Method for creating a double bundle ligament orientation in a single bone tunnel during knee ligament reconstruction |
US7717929B2 (en) | 2003-12-19 | 2010-05-18 | Radi Medical Systems Ab | Technique for securing a suture |
FR2865380B1 (en) | 2004-01-23 | 2006-03-03 | L A R S Laboratoire D Applic E | METHOD FOR ATTACHING TRACTION WIRES TO THE END OF A PROTHETIC LIGAMENT |
US7695503B1 (en) | 2004-06-09 | 2010-04-13 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue attachment |
US7819898B2 (en) | 2004-06-09 | 2010-10-26 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US8109965B2 (en) | 2004-06-09 | 2012-02-07 | Biomet Sports Medicine, LLP | Method and apparatus for soft tissue fixation |
US20120046747A1 (en) | 2004-09-07 | 2012-02-23 | Medicinelodge, Inc. Dba Imds Co-Innovation | Systems and methods for zipknot acl fixation |
US20060067971A1 (en) | 2004-09-27 | 2006-03-30 | Story Brooks J | Bone void filler |
US7468074B2 (en) | 2004-10-29 | 2008-12-23 | Arthrex, Inc. | Ligament fixation using graft harness |
US7905903B2 (en) | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US8128658B2 (en) | 2004-11-05 | 2012-03-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US7857830B2 (en) | 2006-02-03 | 2010-12-28 | Biomet Sports Medicine, Llc | Soft tissue repair and conduit device |
US7658751B2 (en) | 2006-09-29 | 2010-02-09 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US8137382B2 (en) | 2004-11-05 | 2012-03-20 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US7749250B2 (en) | 2006-02-03 | 2010-07-06 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US8840645B2 (en) | 2004-11-05 | 2014-09-23 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8118836B2 (en) | 2004-11-05 | 2012-02-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8088130B2 (en) | 2006-02-03 | 2012-01-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US7914539B2 (en) | 2004-11-09 | 2011-03-29 | Biomet Sports Medicine, Llc | Tissue fixation device |
ATE492218T1 (en) | 2005-03-30 | 2011-01-15 | Arthrex Inc | HIGH-STRENGTH CHAIN-LIKE SEAM WITH LOOP FOR KNOTLESS FASTENING |
US20070083236A1 (en) | 2005-06-24 | 2007-04-12 | Smith & Nephew, Inc. | Methods and devices for tissue repair |
US20060293709A1 (en) | 2005-06-24 | 2006-12-28 | Bojarski Raymond A | Tissue repair device |
US20070021839A1 (en) | 2005-07-21 | 2007-01-25 | William Lowe | Trapezium prosthesis and method |
FR2893836B1 (en) | 2005-11-29 | 2008-10-10 | Pierre Imbert | SURGICAL IMPLANT WITH EXTRA CORTICAL SUPPORT FOR LIGAMENTARY TRANSPLANT |
US20070162123A1 (en) | 2005-12-20 | 2007-07-12 | Whittaker Gregory R | Materials and methods for ligament reconstruction |
US8323338B2 (en) | 2005-12-22 | 2012-12-04 | Smith & Nephew, Inc. | Tissue graft fixation |
US20090306776A1 (en) | 2006-01-25 | 2009-12-10 | Children's Medical Center Corporation | Methods and procedures for ligament repair |
US8801783B2 (en) | 2006-09-29 | 2014-08-12 | Biomet Sports Medicine, Llc | Prosthetic ligament system for knee joint |
US9468433B2 (en) | 2006-02-03 | 2016-10-18 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US8968364B2 (en) | 2006-02-03 | 2015-03-03 | Biomet Sports Medicine, Llc | Method and apparatus for fixation of an ACL graft |
US9078644B2 (en) | 2006-09-29 | 2015-07-14 | Biomet Sports Medicine, Llc | Fracture fixation device |
US8562647B2 (en) | 2006-09-29 | 2013-10-22 | Biomet Sports Medicine, Llc | Method and apparatus for securing soft tissue to bone |
US7959650B2 (en) | 2006-09-29 | 2011-06-14 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
EP1832246B1 (en) | 2006-03-08 | 2019-06-12 | Arthrex, Inc. | Bundle graft and method of making same |
US8298284B2 (en) | 2006-03-21 | 2012-10-30 | Arthrex, Inc. | Whip stitched graft construct and method of making the same |
US20070225805A1 (en) | 2006-03-21 | 2007-09-27 | Reinhold Schmieding | Ligament Fixation Using Graft Harness/Bolt Assembly |
US8852250B2 (en) | 2006-05-18 | 2014-10-07 | Linvatec Corporation | Graft fixation implant |
DE602007003529D1 (en) | 2006-08-16 | 2010-01-14 | Arthrex Inc | Button and continuous loop for fixing ribbons |
US8882833B2 (en) | 2006-08-16 | 2014-11-11 | Arthrex, Inc. | Drill pin for fixation of ligaments using button/loop construct |
US7776039B2 (en) | 2006-09-25 | 2010-08-17 | Joseph Bernstein | Anterior cruciate ligament tether |
US8500818B2 (en) | 2006-09-29 | 2013-08-06 | Biomet Manufacturing, Llc | Knee prosthesis assembly with ligament link |
US7686838B2 (en) | 2006-11-09 | 2010-03-30 | Arthrocare Corporation | External bullet anchor apparatus and method for use in surgical repair of ligament or tendon |
AU2007339257B2 (en) | 2006-12-27 | 2013-01-10 | Shriners Hospitals For Children | Woven and/or braided fiber implants and methods of making same |
US7901431B2 (en) | 2007-01-17 | 2011-03-08 | Arthrex, Inc. | Lisfranc repair using suture-button construct |
US7875058B2 (en) | 2007-01-17 | 2011-01-25 | Arthrex, Inc. | Bunion repair using suture-button construct |
US7875057B2 (en) | 2007-01-19 | 2011-01-25 | Arthrex, Inc. | Method and suture-button construct for stabilization of cranial cruciate ligament deficient stifle |
US20080188936A1 (en) | 2007-02-02 | 2008-08-07 | Tornier, Inc. | System and method for repairing tendons and ligaments |
US20080234819A1 (en) | 2007-02-15 | 2008-09-25 | Reinhold Schmieding | All-inside double-bundle acl reconstruction |
US8147546B2 (en) | 2007-03-13 | 2012-04-03 | Biomet Sports Medicine, Llc | Method and apparatus for graft fixation |
CA2682701A1 (en) | 2007-03-20 | 2008-09-25 | Serica Technologies, Inc. | Prosthetic device and method of manufacturing the same |
US7766964B2 (en) | 2007-03-30 | 2010-08-03 | Biomet Sports Medicine, Llc | In situ graft preparation for knee ligament reconstruction |
DE602008006181D1 (en) | 2007-04-19 | 2011-05-26 | Smith & Nephew Inc | GRAFT FIXATION |
EP1987803A3 (en) | 2007-05-01 | 2009-05-27 | Arthrex, Inc. | Expanding plug for tendon fixation |
US8652139B2 (en) | 2007-05-02 | 2014-02-18 | Arthrex, Inc. | Flip retrograde cutting instrument |
US8663324B2 (en) | 2007-06-29 | 2014-03-04 | Arthrex, Inc. | Double socket ACL reconstruction |
US8696716B2 (en) | 2007-08-02 | 2014-04-15 | Proactive Orthopedics, Llc | Fixation and alignment device and method used in orthopaedic surgery |
HUP0700524A2 (en) | 2007-08-10 | 2010-01-28 | Pecsi Tudomanyegyetem | Cartilage allograft for replacement of cartilage damages, and process and accessories for producing thereof |
US7905918B2 (en) | 2007-08-23 | 2011-03-15 | William Wayne Cimino | Elastic metallic replacement ligament |
US8162997B2 (en) | 2007-11-05 | 2012-04-24 | Steven Struhl | Device for treatment of acromioclavicular joint dislocations |
US8206445B2 (en) | 2008-01-21 | 2012-06-26 | Ion Surgical Technologies, Inc. | Method of arthroscopically assisted ligament reconstruction |
GB0801956D0 (en) | 2008-02-02 | 2008-03-12 | Imp Innovations Ltd | Adjustable ligament graft fixation |
US8062363B2 (en) | 2008-02-27 | 2011-11-22 | Xircon Limited | Tendon repair apparatus and method |
US8110000B2 (en) | 2008-03-06 | 2012-02-07 | Collins Evan D | Ligament reconstruction system |
US20090234451A1 (en) | 2008-03-12 | 2009-09-17 | Manderson Easton L | Method and system for graft ligament attachment |
US20110046734A1 (en) | 2008-03-13 | 2011-02-24 | Tavor (I.T.N) Ltd. | Ligament And Tendon Prosthesis |
US7998203B2 (en) | 2008-06-06 | 2011-08-16 | Blum Michael F | Total knee prosthesis and method for total knee arthroplasty |
US20100049258A1 (en) | 2008-08-19 | 2010-02-25 | Dougherty Christopher P | Single tunnel double bundle posterior cruciate ligament reconstruction |
US8470036B2 (en) | 2008-09-30 | 2013-06-25 | William S. Barnes | Method and apparatus for reconstructing a ligament |
WO2010045207A2 (en) | 2008-10-13 | 2010-04-22 | The General Hospital Corporation | Single tunnel, double bundle anterior cruciate ligament reconstruction using bone-patellar tendon-bone grafts |
GB2464952A (en) | 2008-10-30 | 2010-05-05 | Xiros Plc | Surgical cord |
US20100274355A1 (en) | 2009-01-21 | 2010-10-28 | Mcguire David A | Bone-tendon-bone assembly with cancellous allograft bone block having cortical end portion |
US8206446B1 (en) | 2009-03-10 | 2012-06-26 | Cayenne Medical, Inc. | Method for surgically repairing a damaged ligament |
US8617241B2 (en) | 2009-03-31 | 2013-12-31 | Imds Corporation | Double bundle ACL repair |
US8460379B2 (en) | 2009-03-31 | 2013-06-11 | Arthrex, Inc. | Adjustable suture button construct and methods of tissue reconstruction |
US8491652B2 (en) | 2009-04-22 | 2013-07-23 | The Cleveland Clinic Foundation | Apparatus and method for sequentially anchoring multiple graft ligaments in a bone tunnel |
US8801784B2 (en) | 2009-06-11 | 2014-08-12 | Linares Medical Devices, Llc | Clamping assemblies for securing ligaments to a bone |
EP2263608B1 (en) | 2009-06-19 | 2016-09-07 | Arthrex, Inc. | Bone-tendon-bone suture button construct |
ES2435618T3 (en) | 2009-06-25 | 2013-12-20 | Optonol Ltd. | Fiber matrix to maintain a soft tissue space |
CA2771555C (en) | 2009-08-25 | 2016-09-13 | Fellowship Of Orthopaedic Researchers, Inc. | Trochlear implants and methods of use |
WO2011031854A1 (en) | 2009-09-11 | 2011-03-17 | Allergan, Inc. | Prosthetic device and method of manufacturing the same |
US20110118838A1 (en) | 2009-11-16 | 2011-05-19 | George Delli-Santi | Graft pulley and methods of use |
US20110196432A1 (en) | 2010-01-30 | 2011-08-11 | Griffis Iii Jack C | Method and system for compression and fixation of tendon to bone |
US8398678B2 (en) | 2010-03-15 | 2013-03-19 | Arthrex, Inc. | Hallux valgus repairs using suture-button construct |
US9757132B2 (en) | 2010-03-24 | 2017-09-12 | Biorez, Inc. | Mechanically competent scaffold for rotator cuff and tendon augmentation |
WO2011137159A1 (en) | 2010-04-27 | 2011-11-03 | Synthes Usa, Llc | Anchor assembly including expandable anchor |
US8784423B2 (en) | 2010-05-17 | 2014-07-22 | Arthrex, Inc. | Tibial cross-pin fixation techniques and instrumentation |
US8790394B2 (en) | 2010-05-24 | 2014-07-29 | Valtech Cardio, Ltd. | Adjustable artificial chordeae tendineae with suture loops |
US9649189B2 (en) | 2010-08-23 | 2017-05-16 | Arthrex, Inc. | Reinforced biological construct and method of reinforcing biological construct |
US8409204B2 (en) | 2010-10-12 | 2013-04-02 | Compagnie Financiere et Medicale SARL | Surgical method for repairing a fractured shoulder joint |
US9724188B2 (en) | 2010-10-27 | 2017-08-08 | The General Hospital Corporation | System and method for ligament reconstruction |
EP2455001B1 (en) | 2010-11-17 | 2020-07-22 | Arthrex, Inc. | Adjustable suture-button constructs for ligament reconstruction |
EP2455040B1 (en) | 2010-11-17 | 2015-03-04 | Arthrex, Inc. | Adjustable suture-button construct for knotless stabilization of cranial cruciate deficient ligament stifle |
EP2455002B1 (en) | 2010-11-17 | 2019-04-03 | Arthrex, Inc. | Adjustable suture-button construct for ankle syndesmosis repair |
US8795334B2 (en) | 2011-01-28 | 2014-08-05 | Smith & Nephew, Inc. | Tissue repair |
US9237887B2 (en) | 2011-05-19 | 2016-01-19 | Biomet Sports Medicine, Llc | Tissue engaging member |
US9301745B2 (en) | 2011-07-21 | 2016-04-05 | Arthrex, Inc. | Knotless suture constructs |
US9332979B2 (en) | 2011-07-22 | 2016-05-10 | Arthrex, Inc. | Tensionable knotless acromioclavicular repairs and constructs |
US9259217B2 (en) | 2012-01-03 | 2016-02-16 | Biomet Manufacturing, Llc | Suture Button |
US8998904B2 (en) | 2012-07-17 | 2015-04-07 | Fastforward Surgical Inc. | Winged tether plate and method of use for reducing angular bone deformity |
-
2006
- 2006-07-07 US US11/482,038 patent/US8512376B2/en active Active
-
2013
- 2013-08-19 US US13/970,269 patent/US20130331886A1/en not_active Abandoned
-
2015
- 2015-11-05 US US14/933,269 patent/US10206670B2/en not_active Expired - Lifetime
-
2017
- 2017-04-10 US US15/483,338 patent/US10390816B2/en not_active Expired - Fee Related
-
2019
- 2019-08-16 US US16/542,565 patent/US10695049B2/en not_active Expired - Lifetime
-
2020
- 2020-02-19 US US16/794,494 patent/US10736622B2/en not_active Expired - Lifetime
- 2020-08-10 US US16/988,823 patent/US10918375B2/en not_active Expired - Lifetime
-
2021
- 2021-02-10 US US17/172,473 patent/US20210161518A1/en not_active Abandoned
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2765787A (en) * | 1954-08-02 | 1956-10-09 | Leon L Pellet | Hip arthroplasty with flexible securing means |
US4988351A (en) * | 1989-01-06 | 1991-01-29 | Concept, Inc. | Washer for use with cancellous screw for attaching soft tissue to bone |
US5219359A (en) * | 1990-09-18 | 1993-06-15 | Femcare Limited | Suture apparatus |
US5211647A (en) * | 1992-02-19 | 1993-05-18 | Arthrex Inc. | Interference screw and cannulated sheath for endosteal fixation of ligaments |
US5306290A (en) * | 1993-02-12 | 1994-04-26 | Mitek Surgical Products, Inc. | Suture button |
US5409490A (en) * | 1993-08-16 | 1995-04-25 | Depuy Inc. | Shoulder separation reconstruction |
US20030130694A1 (en) * | 1999-12-02 | 2003-07-10 | Ray Bojarski | Soft tissue attachment and repair |
US20040236373A1 (en) * | 2003-05-20 | 2004-11-25 | Anspach William E. | Surgical method for suturing tendons/ligaments to bones |
Cited By (49)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9072510B2 (en) | 2001-08-30 | 2015-07-07 | Arthrex, Inc. | Acromioclavicular joint fixation technique |
US20110137341A1 (en) * | 2001-08-30 | 2011-06-09 | Brian Thornes | Acromioclavicular joint fixation technique |
US9005245B2 (en) | 2002-08-30 | 2015-04-14 | Arthrex, Inc. | Acromioclavicular joint fixation technique |
US20070179531A1 (en) * | 2002-08-30 | 2007-08-02 | Brian Thornes | Acromioclavicular joint fixation technique |
US11337819B2 (en) | 2003-02-24 | 2022-05-24 | Arthrosurface Incorporated | Trochlear resurfacing system and method |
US20070219558A1 (en) * | 2006-03-15 | 2007-09-20 | Allen Deutsch | Method and apparatus for arthroscopic surgery using suture anchors |
US11471289B2 (en) | 2006-07-17 | 2022-10-18 | Arthrosurface Incorporated | Tibial resurfacing system and method |
US20090099556A1 (en) * | 2007-02-13 | 2009-04-16 | Ricardo Albertorio | Tunnel measuring device for ligament reconstruction |
EP1958591A3 (en) * | 2007-02-13 | 2009-09-23 | Arthrex, Inc. | Intraarticular graft length gauge |
US8048157B2 (en) | 2007-02-13 | 2011-11-01 | Arthrex, Inc. | Tunnel measuring device for ligament reconstruction |
US20080208204A1 (en) * | 2007-02-13 | 2008-08-28 | Arthrex, Inc. | Intraarticular graft length gauge |
EP1958591A2 (en) | 2007-02-13 | 2008-08-20 | Arthrex, Inc. | Intraarticular graft length gauge |
US9072509B2 (en) | 2007-10-12 | 2015-07-07 | Howmedica Osteonics Corp. | Toggle bolt suture anchor kit |
US8162997B2 (en) * | 2007-11-05 | 2012-04-24 | Steven Struhl | Device for treatment of acromioclavicular joint dislocations |
US20090182335A1 (en) * | 2007-11-05 | 2009-07-16 | Steven Struhl | Device for treatment of acromioclavicular joint dislocations |
US20100082045A1 (en) * | 2008-09-29 | 2010-04-01 | Wolf Petersen | Flipp tack pusher |
US8795293B2 (en) | 2008-09-29 | 2014-08-05 | Karl Storz Gmbh & Co. Kg | Flipp tack pusher |
US9265495B2 (en) | 2008-09-29 | 2016-02-23 | Karl Storz Gmbh & Co. Kg | Flipp tack pusher |
US11478259B2 (en) | 2009-04-17 | 2022-10-25 | Arthrosurface, Incorporated | Glenoid resurfacing system and method |
WO2011040917A1 (en) * | 2009-09-30 | 2011-04-07 | Strathmore Industries Inc. | Apparatus and method for a suture button |
US9421007B2 (en) | 2010-12-09 | 2016-08-23 | Arthrex, Inc. | Acromioclavicular joint fixation using suture button contstruct with dog bone-shaped button |
US9138219B2 (en) | 2010-12-29 | 2015-09-22 | Tarsus Medical Inc. | Methods and devices for treating a syndesmosis injury |
US9713463B2 (en) | 2011-01-13 | 2017-07-25 | Howmedica Osteonics Corp | Toggle bolt assembly and method of assembly |
US8840644B2 (en) | 2011-03-24 | 2014-09-23 | Howmedica Osteonics Corp. | Toggle bolt suture anchor |
US9636102B2 (en) | 2011-06-02 | 2017-05-02 | Smith & Nephew, Inc. | Surgical fastening |
US8926661B2 (en) | 2011-06-02 | 2015-01-06 | Smith & Nephew, Inc. | Surgical fastening |
US9060824B2 (en) | 2011-11-17 | 2015-06-23 | Metal Industries Research & Development Centre | Bone screw, method for manufacturing the bone screw, and tool for mounting and removing the bone screw |
US11712276B2 (en) | 2011-12-22 | 2023-08-01 | Arthrosurface Incorporated | System and method for bone fixation |
US20170156726A1 (en) * | 2012-01-24 | 2017-06-08 | DePuy Synthes Products, Inc. | Compression screw system |
US11197667B2 (en) * | 2012-01-24 | 2021-12-14 | DePuy Synthes Products, Inc. | Compression screw system |
US11191552B2 (en) | 2012-07-03 | 2021-12-07 | Arthrosurface, Incorporated | System and method for joint resurfacing and repair |
US11648036B2 (en) | 2013-04-16 | 2023-05-16 | Arthrosurface Incorporated | Suture system and method |
US10695096B2 (en) | 2013-04-16 | 2020-06-30 | Arthrosurface Incorporated | Suture system and method |
US20160166291A1 (en) * | 2013-06-24 | 2016-06-16 | The University Of Toledo | Bioactive Fusion Device |
US9743961B2 (en) * | 2013-06-24 | 2017-08-29 | The University Of Toledo | Bioactive fusion device |
US20150164498A1 (en) * | 2013-12-11 | 2015-06-18 | Arthrex, Inc. | Suture washer |
US10123813B2 (en) | 2014-02-17 | 2018-11-13 | Smith & Nephew, Inc. | Drill guide |
US11766334B2 (en) | 2014-03-07 | 2023-09-26 | Arthrosurface Incorporated | System and method for repairing articular surfaces |
US11607319B2 (en) | 2014-03-07 | 2023-03-21 | Arthrosurface Incorporated | System and method for repairing articular surfaces |
US10499900B2 (en) * | 2014-09-26 | 2019-12-10 | Tensyn Medical, Inc. | Implant devices and systems for stabilized fixation of bone and soft tissue |
US11317903B2 (en) * | 2014-09-26 | 2022-05-03 | Tensyn Medical, Inc. | Implant devices and systems for stabilized fixation of bone and soft tissue |
US20160089131A1 (en) * | 2014-09-26 | 2016-03-31 | Dallen Medical, Inc. | Implant devices and systems for stabilized fixation of bone and soft tissue |
RU2581496C1 (en) * | 2015-06-16 | 2016-04-20 | Федеральное государственное бюджетное военное образовательное учреждение высшего профессионального образования Военно-медицинская академия им. С.М. Кирова Министерства обороны Российской Федерации (ВМедА) | Method for surgical treatment of old and recurrent dislocations of sternal end of clavicle |
US11123121B2 (en) | 2016-05-13 | 2021-09-21 | University Of Virginia Patent Foundation | Coracoclavicular fixation device and related method thereof |
CN109646121A (en) * | 2019-02-15 | 2019-04-19 | 首都医科大学附属北京朝阳医院 | A kind of rotator cuff injury treatment gasket and its application method |
US11478358B2 (en) | 2019-03-12 | 2022-10-25 | Arthrosurface Incorporated | Humeral and glenoid articular surface implant systems and methods |
WO2021195460A1 (en) * | 2020-03-27 | 2021-09-30 | Edwards Lifesciences Corporation | Suture tension distribution |
CN111658231A (en) * | 2020-07-10 | 2020-09-15 | 深圳市第二人民医院(深圳市转化医学研究院) | Fixing device for joint dislocation or ligament reconstruction |
RU2798680C1 (en) * | 2022-11-24 | 2023-06-23 | федеральное государственное бюджетное образовательное учреждение высшего образования "Башкирский государственный медицинский университет" Министерства здравоохранения Российской Федерации | Surgical treatment of dislocations of the sternal end of the clavicle |
Also Published As
Publication number | Publication date |
---|---|
US20210161518A1 (en) | 2021-06-03 |
US20200214688A9 (en) | 2020-07-09 |
US20190365375A1 (en) | 2019-12-05 |
US10695049B2 (en) | 2020-06-30 |
US20160051250A1 (en) | 2016-02-25 |
US20130331886A1 (en) | 2013-12-12 |
US10206670B2 (en) | 2019-02-19 |
US20170209140A1 (en) | 2017-07-27 |
US10918375B2 (en) | 2021-02-16 |
US8512376B2 (en) | 2013-08-20 |
US20200367878A1 (en) | 2020-11-26 |
US20200196997A1 (en) | 2020-06-25 |
US10390816B2 (en) | 2019-08-27 |
US10736622B2 (en) | 2020-08-11 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8512376B2 (en) | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder | |
US5810854A (en) | Method and apparatus for attaching connective tissue to each other or underlying bone | |
US9814565B2 (en) | Method for soft tissue repair with free floating suture locking member | |
US9226742B2 (en) | Restricted wedge suture anchor and method for soft tissue repair | |
US9149312B2 (en) | Clavicle fixation | |
AU784963B2 (en) | Threaded suture anchor | |
US5702462A (en) | Method of meniscal repair | |
US9034014B2 (en) | Free floating wedge suture anchor for soft tissue repair | |
US8597336B2 (en) | Apparatus for discrete tissue anchoring for soft tissue repair and method of use | |
US20110137341A1 (en) | Acromioclavicular joint fixation technique | |
US20220079627A1 (en) | Knotless syndesmosis system | |
IES84791Y1 (en) | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder | |
IE20060551U1 (en) | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder | |
IES20060551A2 (en) | Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: ARTHREX, INC., FLORIDA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:THORNES, BRIAN;REEL/FRAME:018347/0060 Effective date: 20060730 |
|
STCF | Information on status: patent grant |
Free format text: PATENTED CASE |
|
FPAY | Fee payment |
Year of fee payment: 4 |
|
MAFP | Maintenance fee payment |
Free format text: PAYMENT OF MAINTENANCE FEE, 8TH YEAR, LARGE ENTITY (ORIGINAL EVENT CODE: M1552); ENTITY STATUS OF PATENT OWNER: LARGE ENTITY Year of fee payment: 8 |